KETAMINE FOR PROVIDERS & PRESCRIBERS
Referring a Patient for IV Ketamine
AlphaOmega Wellness is a physician-led IV ketamine clinic in Greenwood, Indiana. Since 2018 we’ve provided monitored infusion series for patients with depression, anxiety, and PTSD.
We do not assume psychiatric management. Prescribing stays with you. Below you’ll find our protocol, screening criteria, and how we keep your office in the loop.
PROTOCOL
Treatment & Monitoring
Standard course: six sub-anesthetic intravenous infusions over approximately two to three weeks. Maintenance and booster intervals are set individually based on response and symptom recurrence rather than a fixed schedule.
Supervision: every infusion is conducted under the medical direction of Dr. Dee Bonney, MD — board-certified in emergency medicine, 25+ years in practice, certified in psychedelic-assisted therapies — with a working paramedic present at all times. Our clinical staff aren’t simply ACLS-certified; they are practicing paramedics who use these skills in the field.
Monitoring: continuous vital sign monitoring throughout each infusion, with dose titration and management of intra-infusion hypertension, nausea, or dissociative distress handled on site.
Outcome tracking: PHQ-9 and GAD-7 administered across the series, so response is measured rather than inferred.
Setting: private infusion suites, in-person only. We do not prescribe or dispense at-home oral, sublingual, or compounded ketamine.
MECHANISM & EVIDENCE
Why It Works When SSRIs Haven’t
Ketamine doesn’t work on serotonin. It blocks NMDA receptors, which sets off a glutamate surge and increases BDNF — and that drives the growth of new synaptic connections in the prefrontal cortex and hippocampus. Those are the same regions where chronic stress causes measurable dendritic loss (Li et al., Science, 2010).
Because that pathway is separate from the monoamine system, patients can respond even after multiple failed SSRI, SNRI, and augmentation trials (Zarate et al., 2006); (Murrough et al., 2013).
Onset is usually hours to days rather than weeks — which matters when a patient is actively suicidal (Wilkinson et al., 2018). Randomized data also support use in chronic PTSD (Feder et al., 2014), (Feder et al., 2021).
IV ketamine is FDA-approved as an anesthetic and is used off-label for mood and trauma-related disorders. Patients are consented accordingly.
SCREENING
Referral Criteria
Appropriate referrals
- Treatment-resistant depression — inadequate response to two or more adequate antidepressant trials
- MDD with prominent anhedonia or psychomotor retardation
- Chronic PTSD, including moral injury presentations in first responders and veterans
- Generalized or social anxiety refractory to pharmacotherapy and psychotherapy
- Patients with suicidal ideation who are stable for outpatient management and would benefit from rapid onset
- Patients who have failed or not tolerated esketamine
Exclusions & cautions
- Active or historical psychotic disorder
- Current mania or inadequately controlled bipolar I
- Uncontrolled hypertension or clinically significant cardiovascular disease
- Increased intracranial or intraocular pressure
- Active substance use disorder, particularly involving dissociatives
- Pregnancy or breastfeeding
- Acute suicidal crisis requiring inpatient-level care — an outpatient series is not a substitute for stabilization
We complete our own medical and psychiatric intake on every patient, including full medication reconciliation and cardiovascular review, and we decline patients we do not consider appropriate. A referral is not a commitment on your part or ours.
If a case is borderline, call us before sending them. We would rather have the conversation.
CO-MANAGEMENT
Your Patient Stays Your Patient
Prescribing stays with you
We do not adjust, add, or taper psychiatric medications. Most patients continue their existing regimen throughout the series. When a patient raises tapering, we direct them back to you.
Concomitant medications
We review the full medication list at intake. Benzodiazepines and lamotrigine have been reported to attenuate ketamine’s effects in some patients; where relevant, we will discuss timing with you rather than making changes ourselves.
Records & communication
With a signed release we can share intake findings, PHQ-9 and GAD-7 trends, response notes, and anything clinically relevant that emerges during the series.
WHAT ELSE THE PATIENT GETS
Structured Integration, Included
Every patient receives our Brain Health Reboot curriculum at no additional cost — structured psychoeducation covering the neurobiology of treatment, expectations across the series, and skills-based tools drawn from CBT, DBT, and ACT frameworks. It is educational, not psychotherapy, and it does not replace a therapist.
The rationale is straightforward: the post-infusion period appears to be one of elevated plasticity, which creates capacity for change without directing it. Structured behavioral input during that window is, in our clinical experience, what separates durable response from transient response.
How to Refer
No formal referral is required. Patients can book a free consultation directly, or you can send them the link and we take it from there.
To discuss a case first, call 317-300-4091 and ask to speak with Dr. Bonney or Megan Bonney, PMHNP-BC.
Coverage: IV ketamine is generally not covered by insurance. We accept HSA and FSA, offer financing, and provide first responder and veteran discounts. Pricing is discussed at the free consultation.
AlphaOmega Wellness • 1777 W Stones Crossing Rd, Suite 140, Greenwood, IN 46143
Serving Greenwood, Indianapolis, Carmel, Fishers, and Central Indiana
Working with a patient’s therapist? See our page for therapists →
Selected References
- Li N, et al. mTOR-dependent synapse formation underlies the rapid antidepressant effects of NMDA antagonists. Science. 2010. PubMed
- Zarate CA, et al. A randomized trial of an NMDA antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006. PubMed
- Murrough JW, et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry. 2013. PubMed
- Wilkinson ST, et al. The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and IPD meta-analysis. Am J Psychiatry. 2018. NIH / PMC
- Feder A, et al. Efficacy of intravenous ketamine for treatment of chronic PTSD: a randomized clinical trial. JAMA Psychiatry. 2014. PubMed
- Feder A, et al. A randomized controlled trial of repeated ketamine administration for chronic PTSD. Am J Psychiatry. 2021. Am J Psychiatry
IV ketamine is FDA-approved as an anesthetic and is used off-label for mood and trauma-related disorders. Individual results vary.
Medically reviewed by Dee Bonney, MD — Board-Certified Emergency Medicine, Medical Director, AlphaOmega Wellness. Last reviewed: July 2026. Meet our team →