What ketamine treatment is — and who it’s for
By Jenny Peterson
The billboards across Charleston are hard to miss. Clean, clinical, and featuring a word that still feels loaded: ketamine.
The name alone raises questions: What is it? Is it safe? And who is it meant to help?
The answers aren’t found along the roadside. They’re found inside softly lit treatment rooms at the Charleston Ketamine Center, where physicians are tackling one of psychiatry’s most stubborn problems: treatment-resistant depression.
According to the National Institute of Mental Health, treatment-resistant depression affects nearly 3 million people in the United States. When standard antidepressant medications like Prozac, Zoloft, Wellbutrin, or Effexor stop working, patients can feel stuck.
Many think depression is merely a feeling of sadness. However, depression can also be thought of as depressed brain function. It affects different people in different ways, touching all aspects of a person’s life.
Symptoms include:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
Ketamine has been shown to be very effective at treating these symptoms when standard therapies fail.
“It’s for people for whom depression and anxiety is affecting their daily life,” said Dr. Richard Bowen, owner of Charleston Ketamine Center, with locations in Mount Pleasant and Columbia. “If somebody is seeking medical attention for depression, it’s probably pretty bad.”
With a typical course of six infusions over two weeks, Dr. Bowen says some patients experience rapid change.
“I’ve seen somebody who can’t get out of bed or brush their teeth to, within a week, they’ve got makeup on, they’re dressed and looking for a job,” Dr. Bowen said.
Over more than a decade, he has treated nearly 3,000 patients and administered more than 30,000 ketamine infusions.
How It Works
There is evidence that ketamine increases the number of synapses in parts of the brain. Unlike traditional antidepressants, which can take weeks to work, ketamine can act rapidly — occasionally within a day. Most patients who respond start to notice subtle improvement in their symptoms the day of or the day after their second or third infusion.
What a Treatment Session Feels Like
From more than a decade of experience, Dr. Bowen tailors dosages to each patient.
“On the first visit, we start all patients at a very low rate of infusion and slowly increase the dose every 10 minutes until the patient experiences some dissociation from reality,” he explained. “Getting the patient to that point is important because that is where we see maximum benefit.”
The adjective patients commonly use to describe the experience is “weird.” Most patients find it interesting.
Patients sit in reclining chairs in private rooms while ketamine is delivered through an IV infusion. They remain awake but often enter a dreamlike state. Infusions can be adjusted or paused at any time. Normal awareness returns within minutes after the infusion ends.
“If people get too anxious, we can turn it around real quick,” Dr. Bowen said.
Inside the Treatment Room
The environment is intentionally calm — dim lighting, soft music, and minimal distraction. Patients often wear eye masks and rest quietly. Medical staff monitor vital signs throughout.
Because the effects linger briefly, patients must arrange transportation home.
Outcomes, Expectations and Cost
Standard treatment begins with six infusions over two weeks, followed by maintenance sessions which are usually needed. Some patients also receive low-dose at-home lozenges in order to prolong the benefit of the infusions.
“We get about an 80 percent response rate for depression and about 90 percent for anxiety,” Dr. Bowen said. Some patients experience relief for months, while others require ongoing care.
Each infusion costs $400 and is not covered by insurance, as ketamine is used off-label for psychiatric treatment.
Outcomes vary, Dr. Bowen said, but the impact can be profound.
“It is not uncommon for patients to be totally transformed,” he said. “I have patients hugging me, saying, ‘thank you for saving my life.’ That never happened when I got a patient’s blood pressure under control.”
Dr. Bowen encourages anyone who wants to see if they are a candidate for ketamine treatment to call him on his personal cell at 843-509-1254 or the office at 843-480-2273.
