When Jason Prinzo was diagnosed with depression, he was five years old.

His father was an alcoholic and a drug addict who was prone to violence, and therapy became a fixture in his childhood. But in sixth grade, he quit going. He said the embarrassment of being pulled out of class to meet with the school’s social worker was worse than whatever was happening inside his head.

“I was embarrassed by the diagnosis, so I just didn’t tell anybody,” Prinzo said.

He said after that, he got married and built a life that, “by any outside measure, looked like a good one.” Prinzo is now a mental health advocate and motivational speaker. 

By the time he entered his 40s, he had cycled through a handful of medications without finding lasting relief.

“You start something new, you’re hoping it works, you find out it doesn’t,” Prinzo said. “Then you have to wean off that one while you’re starting a new one.”

Eventually, his psychiatrist diagnosed him with treatment-resistant depression.

The Cleveland Clinic defines treatment-resistant depression as a condition in which a patient does not improve after at least two antidepressants. Of the 8.9 million American adults treated for major depressive disorder, 2.8 million are considered treatment-resistant.

For some with treatment-resistant depression, ketamine, a Vietnam War-era surgical anesthetic turned club drug now being used to treat severe depression, is what works when nothing else does. Clinical studies have found response rates between 60% and 70% in patients with the major depressive disorder.

In 2017, Prinzo decided to try ketamine. Unlike traditional antidepressants, it is administered through a series of IV sessions under medical supervision.

Prinzo received treatment at IV Solution and Ketamine Centers of Chicago, a ketamine clinic in the River North neighborhood. Founder and Medical Director Dr. Bal Nandra is a practicing anesthesiologist who has overseen more than 15,000 ketamine infusions since opening the clinic in 2017.

After completing an initial course of six infusions over two weeks, Prinzo started feeling different.

“I just noticed feeling lighter, I was in a better mood, and I noticed again that I had four or five good days in a row,” Prinzo said. “I totally didn’t believe it would work until it did.”

He added that ketamine was an important step in his recovery process.

According to Dr. Brandon Hamm, a psychiatrist at Northwestern Medicine who runs the hospital’s Ketamine Infusion Clinic, the drug works differently from traditional antidepressants. By blocking receptors in the brain known as N-methyl-D-aspartate, or NMDA, it triggers a burst of neural activity that researchers believe can rapidly relieve depression symptoms.

“There’s very few treatments that are as fast as ketamine,” Hamm said. “It’s one of the fastest things out there, both for depression response and for resolving suicidal ideation.”

Clinical studies published by the National Institutes of Health have shown that ketamine can reduce suicidal thoughts within a single day, with effects lasting up to a week.

For Prinzo, that speed proved lifesaving during a suicidal episode in 2021.

“One treatment of ketamine was able to clear those thoughts out of my mind,” Prinzo said. “When I say ketamine saved my life, it absolutely saved my life.”

However, its antidepressant effects are not permanent, and depression symptoms can return once a patient stops treatment. Nandra said that most patients require maintenance infusions every three to four weeks to sustain their response.

Currently, ketamine is only approved by the Food and Drug Administration as an anesthetic, not for psychiatric use. This means most insurers won’t cover it. Clinicians who prescribe it for mental health do so off-label, a practice that allows physicians to use approved drugs for unapproved purposes.

Without coverage, patients pay anywhere from $275 to $1,300 out of pocket per infusion, putting treatment out of reach for many who can’t afford it.

In response, Nandra founded the Serenity Foundation, a nonprofit that provides need-based financial assistance to patients who cannot afford ketamine treatment.

“We started the foundation so we could help people who really just can’t afford it, or who just need a supplement,” Nandra said.

Since its start, the organization has funded nearly 3,000 infusion sessions and raised around $800,000, more than 95% of which has gone directly to patients.

“Some of the people that need the most help are the ones that struggle financially,” Prinzo, who has since joined the foundation’s board, said.

For Brandon Lutts, another patient of the IV Solution and Ketamine Centers of Chicago, that discount made all the difference.

Lutts was living in Grand Rapids, Michigan, when a friend told him about Chicago IV Solutions. Diagnosed with depression in 2019, he had tried three antidepressants, one of which left him with side effects worse than the depression itself.

“I felt like an empty shell,” he said. “It’s like somebody pulled the electric cord out.”

Having lost his job as a result of depression, the out-of-pocket cost put ketamine therapy out of reach. Then, he heard about the Serenity Foundation. Lutts applied, was approved and drove to Chicago for treatment.

“I sat down as one person, and when I woke up an hour and a half later, I felt like an entirely different human being,” Lutts said. “It was the first time I had felt joy in so long.”

In the five years since, he has had close to 30 infusions, all partially subsidized by the foundation. There are clinics closer to home in Grand Rapids, but none offer financial assistance of any kind.

Lutts is still on two antidepressants. He does not see ketamine as a replacement, but as an enhancement that fills a gap in existing mental health treatment.

“You can tell how your prescriptions affect you and keep you at baseline,” he said. “Then you go get an infusion, and you’re like, ‘Oh, there’s this other, next-level version of me that gets to fully express itself without the bounds of limiting depression and apathy and hopelessness.’”

Even as ketamine clinics expand, broader access will likely depend on stronger clinical evidence and regulatory shifts that would allow for ketamine to be formally recognized as a standard treatment for mental health conditions.

Nandra points to Spravato, an esketamine nasal spray approved by the FDA in 2019 for treatment-resistant depression, as a sign of how that shift might happen. 

While some clinicians, including Hamm and Nandra, argue the spray is less effective than IV ketamine, its FDA approval marks the first time a ketamine-related treatment has been cleared for psychiatric use. It could potentially open the door for similar therapies and broader insurance coverage.

“I probably would never have even gone if it had not been for even the chance that the cost would be lower,” Lutts said. “Without it, I don’t even know that I would be here today.”

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