Ketamine Therapy for Treatable Conditions in Victoria, BC

Ketamine Keys Medical Clinic provides Ketamine-Assisted Psychotherapy for adults with treatment-resistant depression, PTSD, severe anxiety, and certain chronic pain conditions. Care is provided by Dr. Jeff Dufresne, CCFP, MD at Synergy Health Centre on Quadra Street in Victoria, BC.

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What Treatable Conditions Do We Address

In clinical practice, Ketamine-Assisted Psychotherapy is utilized for specific, complex conditions when standard first-line treatments have not produced sufficient improvement. The clinical definitions are straightforward, but the lived experience often is not. People in these groups have typically been through standard talk therapy, multiple medication trials, and in many cases medical referrals, without arriving at the relief they had hoped for.

The evidence base supporting ketamine’s use for these conditions has grown substantially over the past decade, and the College of Physicians and Surgeons of BC has issued formal interim guidance recognizing its clinical use in regulated community settings. Ketamine Keys focuses on the following primary indications:

Generally considered present when multiple medications indicated for depression have been tried at an adequate dose and duration without producing sufficient improvement.

For individuals in this group, traditional oral medications often fail to provide sustained relief because they rely on altering monoamine neurotransmitters like serotonin over many weeks. Ketamine therapy offers a different clinical pathway by rapidly stimulating brain-derived neurotrophic factor (BDNF), which helps restore synaptic connections in brain regions deeply affected by prolonged depressive states.

Focused on severe anxiety disorders where standard frontline medications and therapies have been attempted without producing the expected response.

When conventional treatments such as SSRIs, SNRIs, and standard talk therapies provide limited relief, the central nervous system often remains in a chronic state of over-activation. Clinical research indicates that low-dose ketamine administration can help modulate glutamate pathways, disruptive neural loops, and default mode network (DMN) activity, providing a temporary window of cognitive flexibility that can disrupt persistent, severe anxiety cycles.

Including PTSD in veterans, first responders, and trauma survivors, where conventional medication and therapy have provided limited or insufficient relief.

Trauma-induced conditions can leave the brain's threat-detection systems, particularly the amygdala, hyper-reactive and resistant to standard pharmacological interventions. In a clinical setting, ketamine acts on NMDA receptors to temporarily soften the intense emotional payload associated with traumatic memories, creating a supportive neurobiological environment where patients can more effectively process trauma alongside their integration clinicians.

Specifically including chronic neuropathic pain and fibromyalgia managed under physician care, where standard approaches have been insufficient.

Persistent pain conditions often involve a process called central sensitization, where the nervous system amplifies pain signals even after initial tissues have healed. By acting as a potent NMDA receptor antagonist, ketamine therapy can help reset these hypersensitive pain pathways and reduce central nervous system wind-up, offering a distinct mechanism of care for complex pain profiles that do not respond to typical anti-inflammatory or opioid therapies.

How Ketamine Therapy May Help

Ketamine works on the body and brain through a different mechanism than standard medications. Where typical antidepressants or daily anxiety medications target serotonin and norepinephrine systems and typically take weeks to produce a noticeable change, ketamine acts primarily on the glutamate system. This system is involved in how neurons communicate, form connections, and adapt over time. For chronic pain conditions, ketamine acts as an NMDA receptor antagonist, which plays a central role in how pain signals are processed by the nervous system.

For some patients, ketamine therapy produces a clinical response when standard treatments have not. For others, it does not produce the response they had hoped for. The clinic does not predict which patients will respond, and does not guarantee outcomes. What the clinic can offer is a careful clinical assessment, a structured treatment course, and ongoing monitoring of response throughout the course.

The consultation includes a frank discussion of what the current evidence shows and what it does not. Patients are encouraged to ask hard questions and to expect direct answers.

Who is a Candidate

The clinic considers a patient a potential candidate for ketamine therapy when:

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The primary diagnosis of depression, PTSD, severe anxiety, or a relevant chronic pain condition has been established by a physician, psychiatrist, psychologist, or qualified clinician.
Standard first-line medications and treatments appropriate to the condition have been tried at an adequate dose, duration, or frequency without sufficient improvement.
Standard psychotherapy or relevant rehabilitation has been engaged or attempted as part of prior care.
There is no clinical reason or medical contraindication that would make ketamine therapy unsafe for the patient.

Patients may self-refer or be referred by a physician, psychiatrist, psychologist, or counsellor. A formal referral is not required, though clinical notes from the patient's existing care team are helpful and may be requested as part of the consultation process.

Who is Not a Candidate

Ketamine therapy is not a first-line treatment, and it is not appropriate for everyone. A meaningful portion of applicants are found at consultation not to be candidates for care. The clinic does not provide ketamine therapy in the following situations:

Active or untreated psychotic illness, including schizophrenia.
Pregnancy.
Standard psychotherapy or relevant rehabilitation has been engaged or attempted as part of prior care.
Significant uncontrolled cardiovascular conditions, including recent heart attack or uncontrolled hypertension.
Current substance use disorder that creates safety risks during treatment.
Situations where standard psychotherapy, conventional medications, and psychiatric care have not been pursued.

The clinic does not provide ketamine for recreational use, for self-exploration outside a medical context, or for general wellness goals. The cardiovascular screening matters specifically because ketamine can transiently raise blood pressure and heart rate during the session. Patients with cardiovascular conditions are assessed carefully during consultation, and treatment is declined when the risk profile is not appropriate. A consultation is the only way to determine eligibility.

What Treatment Looks Like at Ketamine Keys

A patient who is accepted into care follows the same four-step process the clinic uses for all patients: consultation, preparation, treatment, and integration. The detailed mechanics of each step, including session length, fasting requirements, transportation, and aftercare, are covered in detail on the main Ketamine Therapy page.

A typical initial course is approximately six sessions conducted over a period of weeks. Prior to beginning any treatment sessions, patients receive in-depth clinical instruction pamphlets outlining precisely how to prepare, what to expect, and what to bring. The initial course is followed by an assessment of clinical response and a discussion of whether ongoing maintenance is appropriate.

Integration work, which is where the experience of treatment is translated into changes that matter in everyday life, happens after treatment and is often coordinated with an existing therapist, counsellor, or psychiatrist. For patients without an existing care team, the clinic can refer to a registered psychologist with experience in this area.

Continuing Your Current Care

Most patients who come to Ketamine Keys are already working with a family physician, psychiatrist, psychologist, or counsellor. Ketamine therapy is intended to work alongside that existing care, not to replace it.

Antidepressants and existing medical prescriptions are generally continued during a course of ketamine therapy. Ongoing therapy work with the patient's existing care team is encouraged, and integration sessions are most effective when coordinated with whoever is providing that ongoing care. If you do not currently have a therapist or counsellor and one would be appropriate as part of your care, the clinic can refer you to a registered psychologist with experience in this area.

Frequently Asked Questions

Standard daily medications work on specific neurotransmitter systems and typically take four to six weeks to produce a noticeable response, or require daily adherence to manage chronic pain. Ketamine acts primarily on the glutamate system and NMDA receptors through a different mechanism, and the clinical effects are observed on a different timeline. Standard daily treatments are taken at home; ketamine therapy is delivered in a series of supervised, low, sub-anesthetic doses in a clinic environment.

In most cases, yes. Ketamine therapy can usually be provided alongside common antidepressants and other routine medications. Every medication list is reviewed individually during consultation, and any adjustments are coordinated with your prescribing physician.

Standard practice is to try conventional first-line medications, therapies, or pain management strategies at adequate dose and duration before considering ketamine therapy. If you have not yet been through that process, the appropriate next step is typically to continue working with your family physician, specialist, or psychiatrist on conventional treatment first. The consultation can help clarify where you are in the standard treatment sequence.

This varies considerably between patients and depends on the specific condition being addressed. Some report a noticeable change within the first few sessions. Others do not notice changes until later in the course or in the weeks that follow. Some patients do not experience the response they had hoped for, and the clinic does not predict outcomes or guarantee results.

A typical initial course is approximately six sessions conducted over a period of weeks. Following the initial course, a clinical assessment determines whether further treatment, periodic booster sessions, or a maintenance program is medically appropriate.

A meaningful portion of applicants are found at consultation not to be candidates for ketamine therapy. If the assessment indicates that ketamine therapy is not appropriate for your profile or situation, you incur no fee for the consultation, and Dr. Dufresne will offer guidance on what other steps may be reasonable to discuss with your existing care team.

Take the first step

If you are considering ketamine therapy for a treatable condition and would like to discuss whether it may be appropriate, the first step is a consultation with Dr. Dufresne. There is no fee to the patient for this assessment and no obligation to proceed.

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