2 clinics shown
Dr. David Feifel operates a private psychiatric practice in La Jolla on Holiday Court, providing medication management and psychiatric evaluations for adults. The practice focuses on general psychiatry services rather than procedural interventions like TMS or ketamine therapy. Patients seeking specialized treatment-resistant depression protocols may need to inquire about referrals to facilities offering those modalities.
Kadima Neuropsychiatry Institute operates a La Jolla practice on Holiday Court offering TMS therapy and intramuscular ketamine treatments for adults with treatment-resistant depression and related conditions. The clinic provides psychiatric evaluations and medication management alongside procedural interventions. Both TMS and IM ketamine are administered under direct physician supervision, with treatment protocols tailored to individual patient histories and prior medication trials.
Ketamine therapy is the broader category of clinical ketamine use for mental health conditions including treatment-resistant depression, anxiety, PTSD, OCD, and chronic suicidal ideation. Unlike Spravato (which is the FDA-approved esketamine nasal spray), most ketamine therapy is provided off-label using racemic ketamine — typically through IV infusion, intramuscular injection, or sublingual lozenges.
Treatment is administered in a clinical setting with continuous medical supervision. A typical IV protocol involves six infusions over two to three weeks, with each infusion lasting 40 to 60 minutes. Patients are monitored throughout for blood pressure changes, dissociative effects, and emotional response. Many clinics provide a calm, dimly lit room with eye masks and music to support a contemplative experience during dosing.
Ketamine acts on the brain's NMDA receptors and glutamate system, which is fundamentally different from how SSRIs and other traditional antidepressants work. Many patients report significant improvement within hours to days of their first session — among the fastest-acting antidepressant effects in clinical use.
Because most ketamine therapy is off-label, insurance coverage is limited and most patients pay out of pocket. Clinics in our directory range from anesthesiology-led infusion centers to integrated psychiatric practices offering ketamine alongside therapy.