Ketamine clinics proliferate across city as restrictions shrink and demand swells

A 2023 study led by researchers at the University of Toronto found that at least 30% of people with depression are considered treatment-resistant, meaning their symptoms do not improve after talk therapy and antidepressants. The market is significant: more than one in ten adults use antidepressants, according to data published by the National Center for Health Statistics.

The American Society of Ketamine Physicians, Psychotherapists, and Practitioners has 11 members in the five boroughs listed on its website, but a simple internet search reveals a much denser constellation of clinics offering the drug. While a majority of the locations are in Manhattan, mostly concentrated along a central commercial corridor in Midtown East, the radius is growing, with more sites popping up in Brooklyn and Queens, particularly in posh neighborhoods like Brooklyn Heights and Williamsburg.

One such company, Oradell, N.J.-based Keta Medical Center, has seen demand jump since opening up its first clinic in 2021. In the last year, the number of patient visits across its sites has doubled, from roughly 1,600 visits in the first quarter of 2024 to 3,100 during the same period this year.

The company, which charges $500 for an IV session, opened a new office in Brooklyn Heights this year, its fifth location and third in the five boroughs, to capture the growing market in neighborhoods further removed from the happenings on Madison Avenue. Keta Medical hopes the new site will eventually see between 4,500 and 5,000 patients, in line with its Manhattan locations, said Moshe Malina, the company’s chief operating officer.

Keta Medical isn’t the only company expanding across the city. Financial District-based Being Health opened in January 2024 with $5.4 million in funding from 18 Park and HDS Capital; it offers ketamine treatment sessions for $550 or a package of 6 infusions plus three ketamine-assisted psychotherapy sessions for $4,200, according to its website. Another competitor, Ember Health, raised $1.9 million in a seed round from undisclosed investors in 2023, according to federal filings. The company has five locations in Manhattan and Brooklyn, including a Brooklyn Heights office in the same building as Keta Medical’s new clinic. There are no restrictions on where the clinics may be sited.

To be covered for treatment, patients must have tried traditional antidepressants and talk therapy before being referred to the ketamine clinic, although patients often seek out the service with clinic staff working backwards to get a referral, multiple providers said. Guidelines allow the nasal spray, known by the brand name Spravato, to be used under the supervision of a clinician, who monitors its effect on the heart, among other things. Many clinics also offer intravenous doses of another ketamine derivative that has not been approved for psychiatric use and must be paid for out of pocket.

With more liberal usage and only a nascent body of science behind it, the growing field comes with risks.

“We always worry about expectations. This is a fantastic treatment that, when it works for someone, it works really well,” said Dr. Andrew Spitzberg, physician-in-charge at the Ketamine Treatment Program at Zucker Hillside Hospital in Glen Oaks, which began offering the nasal spray in November. “But it’s not perfect, and it doesn’t work for everyone.”

More research is needed to know the full health and psychological effects of the intravenous infusions and other interventions, like coupling the drug with psychotherapy, which many clinics are doing but which has not been FDA approved, he said. Up until now, the new field has been more focused on treating acute symptoms but less is known about its impacts as a long-term “maintenance” drug, he added.

Ketamine is defined by the Drug Enforcement Administration as a Schedule III controlled substance, meaning it has the potential for abuse and dependency. The drug made headlines recently when Friends star Matthew Perry, who had been receiving ketamine infusion therapy, died of an overdose in 2023 at his home. Spitzberg screens his patients for health risks, like heart conditions and substance use issues, before accepting participants and discourages his patients from drinking alcohol or using marijuana while receiving treatment, he said. Keta Medical screens patients and controls the dosages and intervals of treatments to keep patients from becoming addicted, said Dr. Haviva Malina, an emergency medicine physician and co-founder of Keta Medical Center.

Keta Medical’s new Brooklyn Heights office follows FDA approval of Spravato as a monotherapy in January, meaning it can be taken on its own without other antidepressants, as had previously been the case. The decision will make it easier for patients to begin the therapy and have it be covered by insurance, said Malina, the COO. In its first weeks, the new Brooklyn Heights location has seen new clientele along with some patients who had been commuting from the outer boroughs to its Manhattan sites for the treatment, he said.

“There remains, notwithstanding the growth [in the market], a huge untapped opportunity clinically and as a business matter,”