Innovative Treatments

What treatments are available in Bendigo?

We have experience with ketamine/esketamine (Spravato), psilocybin (for depression) and MDMA (for PTSD) psychedelic assisted therapy (PAT), medicinal cannabis, and repetitive transcranial magnetic stimulation (rTMS) and are able to facilitate these therapies at our convenient Chapel St location.

What are the available innovative treatments for treatment resistant depression (TRD)?

Esketamine nasal spray, IV or sublingual ketamine, rTMS, medicinal cannabis, and psilocybin are all available in Australia, although IV and sublingual ketamine are off-label for depression and generally used for chronic pain.

How do you define treatment resistance?

Having an incomplete or poor response to at least two classes of antidepressants is the minimum definition of treatment resistant depression. For PAT and for Medicare-rebated rTMS, you also need to have engaged in psychotherapy.

What are the available innovative treatments for post-traumatic stress disorder (PTSD)?

MDMA and medicinal cannabis are available for PTSD. There is also emerging evidence for rTMS in PTSD and esketamine/ketamine in PTSD, particularly where there is also depression. 

What are the available innovative treatments for chronic pain?

Medicinal cannabis, ketamine lozenges (troches) and IV ketamine are available for chronic pain in Australia. There are also a number of interventions such as nerve blocks and implants which are offered by interventional pain specialists. We don't have experience with interventional pain management and encourage you to speak with your pain specialist if you're interested in pursuing interventional pain management.

What is the difference between ketamine/esketamine and psychedelic assisted therapy (PAT)?

PAT in Australia refers to using MDMA or psilocybin in conjunction with psychotherapy, which is a requirement of their prescribing. Ketamine and esketamine don't require psychotherapy to be integrated with the medication due to ketamine's history as a controlled (S8) rather than prohibited substance (S9).

What is the time commitment for PAT?

PAT preparatory and integration sessions are like standard psychotherapy sessions, usually 50 minutes, with both your PAT therapists. Dosing sessions are all day, and integration sessions are held in the same room as the dosing session the morning after. This allows you to be reminded of things you might not otherwise remember not being in the same setting and allows you to better integrate the psychedelic experience. 

What is the time commitment or ketamine/esketamine?

Esketamine nasal spray is typically dosed two days a week for up to 8 weeks then maintenance doses, if required, every 1-2 weeks after that. Each session lasts 1-2 hours depending on how your body responds to the medication. 

Can I do psychotherapy while dosing ketamine/esketamine?

Absolutely, and we encourage ketamine assisted therapy (KAT).

What it is the cost?

rTMS: Medicare subsidies are available for the first 35 sessions (an acute course) for treatment resistant depression and further maintenance sessions 4 months later. The total out of pocket at The Bendigo Rainbow Hub is $800 for a course of rTMS with Medicare (approximately $23 per session). Without Medicare, DVA, or health fund, each session is $200. DVA gold card holders and those with mental health accepted conditions are bulk-billed.

esketamine (Spravato): The out of pocket cost is about $100 per session (or $200 per week) after Medicare subsidies. Without Medicare, each session costs $500.

PAT: The cost for a course of PAT in Australia is around $25-35k inclusive of all sessions and medications. Some health funds may cover the costs, as does DVA.

Do I need a referral?

You need a referral to access Medicare-rebates for psychiatry services, but you don't need a referral from your GP for a specific treatment.