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Ketamine treatment for depression

Carolina Behavioral Care is offering a range of treatment options for treatment resistant depression (TRD).  Since 2017, we have provided a Ketamine Infusion Clinic in our Pinehurst office.  This is a highly effective treatment for TRD and we have seen excellent responses to this form of treatment.  Response rates have been demonstrated to be over 70 percent. 

Carolina Behavioral Care has been recently approved by Janssen Pharmaceuticals to administer the new ketamine drug which is delivered by a nasal device.  Esketamine, known as Spravato, has been FDA approved for treatment resistant depression (TRD).  This drug will be supported as a treatment option by most insurance companies and thus more available for the general population of patients suffering from depression.  The criteria for getting approval for treatment is a patient who has not responded significantly to adequate trials of two antidepressant medications.  Only certified treatment centers are allowed to administer Spravato.  For further information about this novel treatment, go to:  spravato.com

Carolina Behavioral Care will have Ketamine clinics at the Pinehurst, Durham, and Hillsborough sites.  They are under the direction of Robert Fleury, MD, and Robert Millet, MD.  Each doctor has over 20 years’ experience in managing complex psychiatric conditions with a special interest in treatment resistant depression (TRD). Dr. Fleury will lead the Pinehurst Clinic and Dr. Millet will lead the Durham and Hillsborough clinics.  The availability of Spravato at CBC is in large part due to the availability of pharmacy and lab services at all three sites.  We will make the drug available at our pharmacies for the patients’ convenience, and also have the medical lab services to support the program. 

Referral for Spravato will need to be coordinated with the patient’s primary provider of psychiatric medications.  We encourage referrals from outside providers, and welcome the opportunity to assist in the care of your patients.  We will provide a consultative and treatment service, with the plan to send treated patients back to their primary psychiatric provider. 

If patients don’t respond to Spravato, we also offer ketamine through an intravenous infusion protocol. This form of treatment has not been FDA approved and therefore insurance companies do not reimburse for this service. Before administering the medication, a thorough psychiatric and medical assessment is undertaken by the Carolina Behavioral Care staff.  The treatment requires four to six sessions, usually every other day for intravenous infusion of Ketamine followed by appropriate monitoring. Follow-up psychiatric monitoring is coordinated by the Carolina Behavioral Care staff. Maintenance therapy is also offered based on individual responses.

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  • Pinehurst office

    289 Olmsted Blvd Pinehurst, NC 28374


  • Hillsborough office

    209 Millstone Drive Hillsborough, NC 27278


  • Durham office

    4102 Ben Franklin Blvd Durham, NC 27704


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Dr. David Cowherd, MD, FACC - Pinehurst Medical Clinic

Carolina Behavioral Care has been my number one choice for my psychiatric referrals for the past 20 years. Their level of professionalism is unsurpassed and I have never been disappointed.


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