Welcome to the Amicus Ketamine Clinic

As of November 2025 our Clinic has been working alongside Dr Amin Vakili to create a safe and supportive environment for patients engaging in Esketamine therapy. The Ketamine Clinic is a quiet space with three comfortable recliners, low lighting and dividers for privacy. We provide a variety of supplies to make sure our patients receive as much comfort and support possible.

Dr Amin Vakili

Dr Amin Vakili has an extensive amount of experience in psychiatry and utilises his hands on approach to support patients through their treatment. Dr Vakili’s treatment room is ajoined to the Clinic which provides easy access and is utilised in Dr Vakili’s hands on approach to patient care. You can read more about Dr Vakili here.

The History of Ketamine in Psychiatry

Early use

  • Ketamine was first developed in the 1960s as a safer alternative to older anaesthetics.
  • It quickly became widely used in surgery, pain management, and emergency medicine because of its rapid action and reliable safety profile.

Discovery of antidepressant effects

  • In the late 1990s and early 2000s, researchers observed that some patients receiving ketamine reported a rapid lift in mood.
  • Controlled studies soon confirmed that even a single infusion of ketamine could ease symptoms of severe depression within hours, even when other medications had failed.

Shift into psychiatry

  • Traditional antidepressants (such as SSRIs) often take 4–6 weeks to work and may not help everyone.
  • Ketamine demonstrated a completely new pathway for treating depression by targeting the glutamate system rather than serotonin or noradrenaline.
  • Because of this, ketamine has been called one of the most important breakthroughs in psychiatric treatment in decades.

Esketamine (Spravato®)

  • Esketamine is a purified form of ketamine, developed specifically for depression treatment.
  • It is delivered as a nasal spray, making administration easier and more consistent than intravenous infusions.
  • Large international clinical trials established its safety and effectiveness for treatment-resistant depression (TRD).
  • Spravato is now approved in several countries, including Australia, the United States, the UK, New Zealand, the European Union, and Canada, under strict supervision protocols.
  • New mechanism: Targets the glutamate system rather than traditional neurotransmitters.
  • Effect: Helps restore brain connections involved in mood, offering hope when other treatments have failed.
  • Approved use in Australia: For adults with treatment-resistant depression—defined as depression not improving after at least two adequate trials of antidepressants.

How Spravato Works

  • Mechanism: Blocks NMDA receptors → increases glutamate activity → promotes the growth of new brain connections.
  • Onset: Some patients notice improvements within days. However maximum response often taken weeks.
  • Supervised treatment: Always administered in clinic under medical supervision.
  • Safety: Each treatment session is followed by at least 2 hours of observation. Patients should not drive for the rest of the day.

Treatment Schedule

Spravato is delivered in 3 phases:

  1. Induction (Weeks 1–4): Two sessions per week.
  2. Continuation (Weeks 5–8): One session per week.
  3. Maintenance (after Week 8): Every 1–2 weeks, depending on your response.

Spravato is always combined with an oral antidepressant (SSRI, SNRI, etc).

Access in Australia

  • Spravato can only be prescribed by psychiatrists.
  • It is administered exclusively in certified clinics equipped for medical observation and monitoring.
  • Since 2025, Spravato has been listed on the Pharmaceutical Benefits Scheme (PBS), making it more accessible to eligible patients.
  • If you are referred by another psychiatrist, our psychiatrist will conduct a comprehensive assessment to confirm your suitability for Spravato.
  • If your referral comes from a GP, our psychiatrist will carry out the initial assessment and, where appropriate, may also organise a second opinion before proceeding with treatment.

Eligibility

You may be eligible for Spravato if:

  • You are an adult with major depressive disorder.
  • You have tried two or more antidepressants without sufficient benefit.
  • You are starting a new oral antidepressant alongside Spravato.
  • You have no medical contraindications (e.g. uncontrolled blood pressure, certain aneurysms, or other conditions assessed by your psychiatrist).

Assessment is always conducted by a psychiatrist to ensure Spravato is safe and suitable for you. In some cases, a second opinion may be sought before treatment begins.

 

Referrals

Referrals can be sent by a GP or Specialist. We encourage an included brief history and any information you deem relevant. Referrals can be sent via Medical Objects or to our practice email. Please feel free to call our rooms to discuss this process with our practice manager.

Amicus Medical Chambers recognizes and pays tribute to the Traditional Custodians of the land in which we operate and reside. We extend our heartfelt acknowledgment to the Elders, both past and present, as well as those emerging. We honor and celebrate the rich narratives, culture, and traditions of Aboriginal and Torres Strait Islander communities who also live and work on this land.