Amid ongoing political, social, and economic uncertainty and tumult, demand for ketamine infusion therapy at the Ketamine Clinic of Spokane LLC has remained steady as patients seek tools to manage depression, anxiety, and emotional overload, often compounded by collective stress, says co-owner Tina Gordon.

“Sometimes our business is a little reflective of what is happening in the world,” Gordon says. “These are very chaotic and challenging times for a lot of people, and people’s mental health is affected.”

Holidays can also act as a major trigger for many people due to family dynamics and emotional stress, Gordon says. Patients often describe ketamine treatment as providing emotional resilience, or a "cloak of protection" during stressful periods. 

The Spokane-based clinic operates in a 1,400-square-foot space at 3707 S. Grand with certified registered nurse anesthetists and offers intravenous ketamine infusions in a controlled medical setting.

While other therapeutic modalities have emerged, including transcranial magnetic stimulation, Gordon says she and her business partner and co-owner, Josh Spartz, have decided to stay focused exclusively on offering IV ketamine treatment due to the clinic’s deep expertise in the drug and a desire to stay focused rather than diversify.  A consistent patient base, including both new referrals and long-term patients, has sustained operations.

The Journal last caught up with the clinic in early 2022. Since then, Gordon says the clinic’s core mission and services have remained largely unchanged, though rising operating costs have prompted adjustments behind the scenes.

After holding prices steady for years, the clinic recently implemented its first rate increase since it opened in 2017. Gordon attributes the roughly 10% adjustment to inflation-driven increases in medical supply costs, staffing wages, and facility expenses, pressures she says are affecting health care providers across the region.

“A lot of business owners in the community are seeing the price of supplies more than doubled or tripled,” Gordon says. “We just reached that tipping point where we had to raise them.”

The clinic’s ketamine treatment regimen consists of six 40-minute infusions over three weeks for mood treatments, as recommended by the National Institute of Mental Health. Each appointment is 1 1/2 hours, which includes time to assess the patient’s response and well-being and a period of rest after the infusion has been administered, Gordon says.

Each infusion is $475, up from $425.

The clinic also offers ketamine infusions for pain treatment that are neuropathic in nature, including chronic migraines, trigeminal neuralgia, and nerve-mediated back pain, Gordon says. Pain infusions last two hours and cost $800 each.

Patients must be referred by a person licensed to provide an appropriate diagnosis, such as a primary health provider, psychiatrist, or psychologist. The clinic treats adults and adolescents as young as 12 years old.

Ketamine treatments are currently not covered by health care insurance plans, Gordon says. The clinic accepts Health Savings Account cards, offers third-party financing, and provides patients with free medically coded superbills including a detailed invoice of services, for insurance claims or tax purposes.

Additionally, the clinic offers a 20% discount to first responders, military, students, and veterans.

Gordon acknowledges that the pricing can be a leap of faith for patients, given that there are no guaranteed outcomes. An estimated 80% of patients experience relief from the treatment, she asserts.

“Our percentage of people for whom it does work is pretty high,” Gordon says. “We feel that in some cases, we are providing a lifesaving service, or we’re giving people who have struggled with treatment-resistant depression for many years, we’re giving them a lifeline.”

The clinic’s growth is largely driven by referrals, word of mouth, and prior media coverage, Gordon says. Traditional marketing methods have yielded limited results and have proven challenging to adapt to the sensitive subject, she says.

“Marketing can be difficult when it's medically related,” Gordon says. “Like a lot of things in Spokane, we’re just like this little secret.”

Gordon says the idea for the clinic emerged after she saw a close friend struggle for years with treatment-resistant depression. Wanting to help, Gordon says she began to search for alternative depression treatment methods. As a certified nurse anesthetist, Gordon had been using ketamine in the operating room for years, but was unaware of the drug's antidepressant effects.

Gordon began further researching the drug’s potential mental health applications, eventually bringing the treatment into a controlled outpatient setting with Spartz.

“I stumbled across it, and so did a lot of digging on the internet,” Gordon says. “It surprised me as an anesthesia provider and as someone who had been using ketamine in the operating room, that it has this antidepressant effect.”

As previously reported by the Journal, ketamine was first developed in the 1960s as an anesthetic drug. It is listed as an essential drug by the World Health Organization and is a commonly used medication in the emergency room and operating room. The U.S. Food and Drug Administration hasn’t approved ketamine infusion therapy for the treatment of mental illness. However, esketamine, a ketamine prescription nasal spray for treatment-resistant depression and major depressive disorder with suicidal ideation, is an FDA-approved form of ketamine treatment.

Gordon says there is a growing body of research that supports the use of ketamine to treat patients with severe, treatment-resistant depression, anxiety, post-traumatic stress disorder, suicidal thoughts, and other mental health conditions. In 2006, the National Institute of Mental Health published a study that concluded that a single intravenous infusion of ketamine delivered rapid antidepressant effects.

Gordon says the clinic was never intended to replace traditional mental health care, but to serve as an option for patients who have exhausted other treatments. By maintaining a narrow clinical focus, she says the clinic has been able to prioritize safety, experience, and long-term patient outcomes.