Providence Care Ketamine Clinic; a new hope for treatment resistant depression

When Jan Crawford first met her husband Gary he was caring, compassionate, strong, and had a great sense of humour.

The couple married in 1988.

Those first few years, there was non-stop laughter.

“Gary was hysterically funny,” Jan chuckled.

“On Saturday mornings we would sit sometimes till noon, drinking coffee, talking and just laughing.”

Gary was also active.

An avid runner, he belonged to clubs, competed in races and coached track and field teams.

“In high school I was the fastest sprinter in Toronto,” recalled Gary.

“I used to run 100 and 200 metres. It’s a natural high, there’s nothing like it.”

But as the years went by, Gary stopped lacing up his sneakers and the jokes were few and far between.

Activities that once interested him didn’t matter anymore, he started isolating himself from society and any confidence he had was gone.

“I didn’t want to go out. I lost interest in doing anything, going anywhere, being around people.”

Gary was diagnosed with clinical depression.

“At the time, I knew nothing about depression,” said Jan.

“Gary calls it a fog in a pit of despair.”

By 1998, a decade into the Crawford’s marriage, his illness got so bad he was put on long-term disability.

“I wouldn’t do anything. I’d sit on the couch and watch TV. It’s like I didn’t have a life and days would just go by,” explained Gary.

“When you’re severely depressed your personal hygiene goes out the window,” added Jan.

“Gary has lost some teeth. He wouldn’t have showers or take care of himself.”

The couple, originally from Toronto now live in Cobourg.

Over the years, they tried everything to treat Gary’s depression.

“I’ve been on about 45 different anti-depressants, they didn’t work. I had a pace-maker put in me, that didn’t work. I had 15 shock treatments, those didn’t work,” said Gary.

He also saw numerous therapists and attended countless group therapy sessions.

Now 71, Gary is still living with his mental illness.

“It’s beyond frustrating and so discouraging, but when you’re desperate you’ll try anything,” Jan explained, holding back tears.

“He’s had depression for more than half our marriage. For over 20 years there’s been very little laughter and no joy in our house.”

That is until one fateful day in spring.

Jan was watching the news when she heard the word ketamine for the first time.

The story explained how it was being used to treat depression.

“I just happened to be watching and I thought, let’s give this a shot. I also have a very strong faith and I thought the Lord is giving this to me.”

Energized Jan called the news station and learned Providence Care Hospital has a Ketamine Clinic.

“Ketamine is a fast-acting anesthetic that’s being used for people with depression who have not responded to other treatments,” explained Dr. Gustavo Vazquez, a physician with Providence Care’s Mood Disorders service.

“The drug has been around for many, many years, but for people with depression it’s a new hope.”

The clinic is an hour and a half drive from Cobourg, but the couple wasn’t concerned about the distance.

“When we first met Gary he didn’t talk very much, he didn’t interact a lot and he didn’t laugh at all,” recalled Dr. Emily Hawken, Research Assistant.

“He moved very slowly and looked quite depressed. He was an ideal candidate.”

Gary started receiving treatment in June 2019.

Here’s how the clinic works.

Clients must sign a consent form before every ketamine treatment.

They go through a physical examination which includes an electrocardiogram and bloodwork.

Their vitals are also checked and they’re weighed.

Dosage is based on how much a client weighs.

The ketamine is given by an intravenous (IV) infusion and lasts about 40 minutes, during which their heart rate and blood pressure are monitored.

Once the infusion is over, recovery lasts about 30 minutes.

“It’s a very safe treatment but clients may have an out of body experience, what we call dissociative symptoms. It’s brief but it’s pleasant for most of our clients,” explained Vazquez.

“For Gary, he had treatments three times a week for a month, then once a week for a month and right now he’s seeing us once every two weeks for the next two months.  After that, it will be once a month for approximately three months,” added Hawken.

And it didn’t take long for Gary to start to feel different.

“There was a slight glimmer after the second treatment, but by the third I started wanting to do things. I remember I walked into a store and everything seemed so bright, like all the items in the store were so bright. It’s hard to explain, it’s like I had a fog or screen over my face, but now it’s lifting,” he explained.

“I see a real change. We’re laughing more now and he’s going out with people. I’m starting to get my husband back,” beamed Jan.

“The team at Providence Care is amazing. We call them the dream team. Everyone has been so supportive and very understanding. This has been a lifesaver.”

And he isn’t the only one in the clinic responding well to the treatment.

“We have a response rate around 60 to 65 percent. It’s very encouraging because most of those clients had already tried a lot of other treatments without success,” said Vazquez.

“It’s giving people who were previously out of options, another option,” added Hawken.

“Gary is coming alive and to witness someone come back to life is wonderful, and it’s a real privilege for our team to have a hand in this.”

And while some clients are responding well to the ketamine, not much is known about the long-term effects of the drug.

“There’s actually a multi-site Ontario study being conducted that’s assessing the safety and tolerability of ketamine for treatment resistant depression. Providence Care is one of the five sites involved,” explained Hawken.

“Our main goal is to help our clients with severe depression but at the same time we’re doing research to try to understand how ketamine really works, and which individuals would benefit from this treatment,” Vazquez added.

People like Gary.

“I think about all the things I want to do now. It gives me hope,” he smiled.

The 71-year-old joined a gym and is lacing up his running shoes again.

That’s because he has a big goal he’d like to accomplish.

“I’ve always wanted to run the Boston Marathon, so I’d like to train for that.”

And thanks to Drs. Vazquez and Hawken, and the rest of the Ketamine Clinic team at Providence Care, Gary is one step closer to achieving his dream of crossing that finish line.