We are a member of The American Society of Ketamine for Physicians, Psychotherapists & Practitioners

The Bulawayo Ketamine Clinic (BKC) was established by a team of senior psychiatrists and an anesthetist to provide carefully monitored ketamine infusion therapy for patients living with severe and treatment-resistant mood disorders. Our clinic is located at Mater Dei Hospital in Bulawayo and operates within established medical guidelines, ensuring safe administration and integrated psychiatric care.

Ketamine has been used worldwide as an anaesthetic for decades. More recently, research has shown its effectiveness in addressing mental health conditions such as depression, bipolar depression, PTSD, and suicidal thinking, especially in cases where conventional medications and therapies have not provided adequate relief. Recognising the need for alternative approaches, our team opened the Bulawayo Ketamine Clinic to make this evidence-based treatment accessible in Zimbabwe.

The clinic operates on a referral basis. In line with local practice, psychiatrists first assess each patient and, if ketamine therapy is considered appropriate, provide a referral to our anaesthetist for treatment. This collaborative model ensures that care is consistent, medically sound, and integrated into the patient’s broader mental health plan.

At BKC, safety is our highest priority. Each infusion is administered in a hospital setting under close medical supervision, with continuous monitoring of vital signs. Patients remain awake throughout treatment, and any side effects such as mild nausea are managed immediately by the attending team.

Beyond treatment, we are committed to advancing awareness of ketamine’s role in psychiatry, reducing stigma, and fostering informed conversations about mental health. As members of the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3), we remain aligned with international standards of practice, ethics, and research in this emerging field.

About Ketamine Treatment

What is Ketamine Treatment?

Ketamine is a medicine first synthesised in the early 1960s by American chemist Calvin Stevens, initially as a safer alternative to phencyclidine (PCP), which was effective as an anaesthetic but produced severe hallucinations and agitation. By 1970, ketamine was approved by the U.S. Food and Drug Administration (FDA) for use as an anaesthetic, and it became widely used in both human and veterinary medicine. Its unique pharmacological properties — rapid onset, short duration of action, and relative safety even in high-stress situations — led to its adoption as a battlefield anaesthetic during the Vietnam War. To this day, it remains an essential medicine on the World Health Organization (WHO) list of indispensable drugs.

While ketamine’s role as an anaesthetic is well established, research in the late 1990s and early 2000s began to reveal its remarkable effects on psychological conditions, particularly severe depression and suicidality. Patients who had failed to respond to conventional antidepressants often experienced rapid relief within hours or days of a single controlled dose. This finding sparked a wave of scientific interest in ketamine as a novel psychiatric treatment, fundamentally changing how clinicians approach treatment-resistant mood disorders.

How Ketamine Works in the Brain

Most traditional antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), target neurotransmitters like serotonin, dopamine, or norepinephrine. While these drugs are effective for many people, they usually require weeks of consistent use before benefits are felt, and a significant proportion of patients do not respond adequately.

Ketamine operates differently. It primarily acts as an antagonist at the N-methyl-D-aspartate (NMDA) receptor, a receptor in the brain’s glutamate system. Glutamate is the most abundant excitatory neurotransmitter in the central nervous system and plays a critical role in synaptic plasticity, learning, and memory.

By blocking NMDA receptors, ketamine indirectly enhances activity at another type of glutamate receptor — the AMPA receptor. This increased AMPA activity triggers a cascade of neurobiological effects, including the release of brain-derived neurotrophic factor (BDNF), a protein essential for the growth and maintenance of neurons. The result is increased synaptogenesis — the formation of new connections between brain cells.

In simple terms, ketamine appears to “reset” or “reconnect” neural circuits that have been weakened by chronic stress, trauma, or prolonged depressive states. This explains why many patients experience not only mood improvements but also an increased sense of cognitive clarity and emotional resilience shortly after treatment.

Clinical Use in Mental Health

Over the past two decades, clinical trials and real-world clinical practice have demonstrated ketamine’s efficacy in a range of psychiatric conditions:

Major Depressive Disorder (MDD): Multiple controlled trials show that ketamine can rapidly reduce depressive symptoms in patients who have not responded to standard treatments. The improvement often occurs within hours, in contrast to the weeks needed for SSRIs.
Treatment-Resistant Depression (TRD): Up to 30% of patients with depression do not respond to standard medications. Ketamine has shown particular promise in this group, offering significant symptom relief when other options have failed.
Suicidal Ideation: Perhaps the most striking benefit is ketamine’s ability to rapidly reduce suicidal thoughts. Studies consistently report reductions of 60–80% in suicidal ideation within 24 hours of a single infusion. This makes ketamine a potentially life-saving intervention in crisis situations.
Post-Traumatic Stress Disorder (PTSD): PTSD is often resistant to conventional therapies. Clinical trials suggest ketamine can reduce intrusive memories, hyperarousal, and avoidance behaviours, providing new therapeutic options for trauma survivors.
Bipolar Depression: For individuals with bipolar disorder who experience depressive episodes despite mood stabilisers, ketamine infusions have been shown to offer rapid, safe symptom relief without triggering mania when administered carefully.
Anxiety and Obsessive-Compulsive Disorder (OCD): Preliminary studies indicate ketamine may also help patients with severe anxiety disorders and OCD, although more research is needed.

Administration and Monitoring

In psychiatric practice, ketamine is not used at the high doses common in anaesthesia. Instead, it is administered at low, sub-anaesthetic doses, typically around 1.5 mg per kilogram of body weight, delivered via slow intravenous infusion over 50 minutes.

During the session, patients remain awake but may experience mild, temporary dissociation, changes in perception, or dizziness. These effects usually resolve within an hour. The most common side effect is nausea, which can be treated quickly if it occurs. Serious complications are rare when the treatment is administered in a controlled, clinical environment by trained professionals.

A standard treatment course often involves six infusions over two to three weeks, followed by maintenance infusions at gradually longer intervals depending on the patient’s response. Importantly, ketamine is always provided alongside psychiatric assessment and ongoing monitoring, ensuring it is integrated into a broader treatment plan.

Efficacy and Evidence

The evidence base for ketamine in psychiatry has grown rapidly. Over 200 clinical studies, including randomised controlled trials, have confirmed its rapid antidepressant and anti-suicidal effects. Unlike traditional antidepressants, which may only work in about half of patients, ketamine has demonstrated response rates of 70% even in treatment-resistant populations.

The effect is often noticeable within 24 hours, with improvements in mood, motivation, and outlook. While the benefits of a single infusion may fade after several days, repeated treatments appear to extend the duration of relief, and some patients maintain improvement with periodic maintenance infusions.

Safety and Limitations

While ketamine’s therapeutic potential is significant, it is not a first-line treatment and must be used under strict medical supervision. Ketamine is a controlled substance due to its potential for misuse as a recreational drug, but the dose, context, and supervision in clinical use are entirely different from illicit use.

Long-term studies are ongoing, but current evidence suggests that, when used in controlled settings at therapeutic doses, ketamine is safe and effective. It is not recommended for children.

Conclusion

Ketamine represents one of the most important innovations in psychiatric treatment in decades. By acting on the glutamate system rather than serotonin, it offers a new mechanism of action for patients who have not responded to conventional therapies. Its ability to rapidly reduce depression and suicidal ideation has made it a vital tool for clinicians, particularly in crisis situations.

At Bulawayo Ketamine Clinic, ketamine is administered in a medically supervised, referral-based setting, combining psychiatric expertise with anaesthetic safety. While not a cure-all, ketamine infusion therapy provides hope and relief for patients facing some of the most severe and persistent forms of psychological suffering.

Who is it for?

Ketamine has many medical uses, but in here is where the evidence is strongest:

Treatment-Resistant Depression (TRD)

Some individuals struggle with persistent depression despite trying multiple antidepressants and therapy. For this group, ketamine can provide meaningful relief by acting on the brain’s glutamate system, restoring weakened neural connections and producing improvements in mood that are often noticeable within hours or days rather than weeks.

Major Depressive Disorder (MDD)

Depression disrupts daily functioning, affecting sleep, concentration, and motivation. Conventional medications can be slow to act. Ketamine infusions administered in a clinical setting offer a rapid reduction of depressive symptoms, helping patients regain stability and continue with their ongoing therapy and support.

Post-Traumatic Stress Disorder (PTSD)

PTSD leaves survivors with intrusive memories, nightmares, and heightened arousal that may persist for years. Traditional treatments often provide limited improvement. Ketamine has demonstrated the ability to reduce the intensity of trauma-related symptoms, improving emotional resilience and enhancing the effectiveness of psychotherapy.

Generalised Anxiety Disorder (GAD)

Chronic worry, physical tension, and disrupted sleep are hallmarks of generalised anxiety disorder. For patients who remain anxious despite treatment, ketamine offers a different mechanism of action, calming overactive brain circuits and reducing the burden of constant worry.

Obsessive-Compulsive Disorder (OCD)

OCD is characterised by intrusive thoughts and compulsive rituals that dominate daily life. While SSRIs and behavioural therapy remain first-line treatments, some patients continue to struggle. Ketamine has been shown to interrupt obsessive thought patterns and reduce compulsions, allowing individuals to re-engage more effectively with therapy.

Suicidal Ideation

Acute suicidal thoughts present an immediate risk, and standard antidepressants are often too slow to provide timely relief. Ketamine stands out for its ability to reduce suicidal ideation rapidly, with many patients experiencing significant improvement within 24 hours, making it a valuable intervention in crisis care.

Alcohol Addiction

Dependence on alcohol often leads to relapse despite counselling and medication. Ketamine has been shown to reduce cravings and support new patterns of behaviour by enhancing neuroplasticity, especially when combined with structured addiction recovery programs.

Chronic Pain

Ketamine is also used in managing chronic pain conditions such as neuropathic pain and fibromyalgia. Its action on the central nervous system reduces pain sensitivity and improves tolerance, often where standard pain treatments have failed.

What is the process?

At Bulawayo Ketamine Clinic, ketamine treatment is carefully structured to ensure safety, effectiveness, and continuity of care. Every patient follows a four-step process:

1. Referral and Psychiatric Assessment

All patients begin with an appointment with a psychiatrist. The psychiatrist reviews your full mental health history, current symptoms, and any previous treatments you have tried. This step is essential because ketamine is not suitable for everyone, and underlying conditions such as psychosis, certain heart problems, or substance misuse may need different care. If ketamine is appropriate, the psychiatrist provides a formal referral for infusion therapy. This ensures that treatment is integrated into your broader mental health plan.

2. Pre-Treatment Evaluation and Medical Clearance

Before starting infusions, a detailed medical review is conducted. This may include checking your blood pressure, heart function, and any medications you are currently taking. The anaesthetist, who administers the infusion, works closely with the psychiatrist to ensure that the treatment is safe in your individual case. This stage is important for identifying any risk factors and preparing you for what to expect during the sessions.

3. Ketamine Infusion Course

Treatment begins with a standard course of six infusions, usually given two to three times a week. Each session lasts 50 minutes. The medicine is administered slowly through an IV line while you remain awake and conscious. During the infusion, clinical staff monitor your heart rate, blood pressure, and comfort levels at all times. Some patients may experience temporary dissociation, dizziness, or nausea, but these effects pass quickly and are well managed in the clinic. The gradual series of infusions allows the brain to build and reinforce new neural connections, leading to more sustained improvements in mood and thinking.

4. Maintenance and Follow-Up

After the initial course, many patients choose to continue with “maintenance” infusions, starting twice a month, then monthly, and sometimes tapering off completely. Regular psychiatric follow-ups are scheduled to track progress, adjust treatment if needed, and support long-term recovery. This step ensures that the benefits of ketamine are consolidated and that patients have continuing support beyond the infusion sessions.

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Frequently Asked Questions

1. Are our infusions safe?

Ketamine infusion is administered intravenously at measured doses (commonly 0.5 mg per kg) over a supervised 50-minute session while the patient remains awake and monitored by anaesthetic staff.

Because patients still retain the ability to protect their own airways, breathe normally and usually experience no significant cardiovascular effects, our infusions are considered safe compared with several other anaesthetic agents. The dose you will receive is given as a controlled infusion over 50 minutes for depression and 3-4 hours for chronic pain conditions.

Even though these infusions have a good safety profile, we exercise every caution, and your infusion will be given by doctors and nurses with appropriate training and immediate access to emergency medication and equipment.

During the infusion, modern equipment will monitor your pulse rate, heart tracing, oxygen level, breathing, and blood pressure.

2. Will I have a bad experience during the infusion?

Everybody’s experience is unique. The majority of patients have a peaceful, uplifting, and even exciting experience during each infusion. Many experience feelings of empathy and empowerment.

Usually, there is a floating, rotating feeling with wonderful varied colours and images. Very few patients might have an unpleasant, even frightening experience. This is usually limited to the first infusion and by no means suggests that the infusions won’t work. Usually, subsequent infusions are completely different. A few patients feel nauseous, but we have medication on hand to address this.

3. Will I still need to see my doctor or therapist after infusions?

Absolutely. Do not stop any of your medication unless instructed to do so, and keep your appointments with your psychiatrist, psychologist or GP. After our infusions, cognitive behavioural therapy is generally more effective and should be continued.

4. Can infusions be used alongside other treatments?

Yes, our infusions can be part of a comprehensive treatment plan that includes other medical treatments and psychotherapy.

Many patients find that the infusions enhance the effectiveness of their ongoing therapies, such as cognitive-behavioural therapy (CBT) or medication management. It’s important to discuss all your current treatments with our team to ensure the best possible integrated care approach.

5. How quickly can I return to normal activities after an infusion?

Most patients feel ready to resume normal activities within a few hours after the infusion, though we advise against driving or operating heavy machinery for at least 24 hours following the treatment. As a precaution, a responsible adult should accompany you home and stay with you for a few hours after the infusion.

6. Will I need ‘top-up’ infusions?

Remember that, like any of the traditional antidepressant and mood-stabilising agents, our infusions are not a cure for depression or chronic pain conditions, but it is usually an effective treatment. You may even be able to cut down on your other medication after receiving infusions, but only if advised to do so by your doctor. Most of our patients will benefit from ‘top-up’ infusions – seldom more frequently than monthly and often only once every 6-months or a year.

7. How is ketamine different from regular antidepressants?

Most antidepressants act on serotonin or dopamine and can take weeks to show effects. Ketamine works on the glutamate system and often produces rapid improvements, sometimes within hours.

8. Do I need a referral to receive treatment?

Yes. All patients must first be evaluated by a psychiatrist. If ketamine is appropriate, you will be referred to our anaesthetist for the infusion process.

9. What does a typical treatment course look like?

A standard course includes six infusions over two to three weeks. Each session lasts 50 minutes. Maintenance sessions may be recommended monthly depending on your response.

10. Is ketamine addictive?

Illicit recreational use can lead to misuse, but the doses and supervision used in medical settings are very different. There is no addiction when administered as prescribed in a clinical program.

11. How quickly will I notice results?

Some patients experience relief from depression or suicidal thoughts within hours. For others, improvements may take several sessions. Every individual responds differently.

12. How long do the benefits last?

Relief after an infusion can last days to weeks. Repeated sessions help extend benefits, and some patients continue with maintenance infusions to sustain improvement.

13. Is ketamine therapy covered by medical aid in Zimbabwe?

Currently, ketamine infusions for psychiatric conditions are not covered by medical aid. Patients pay directly for their treatment.

14. Are there risks or side effects?

The most common side effects are nausea, dizziness, or mild dissociation during the infusion. Serious complications are very rare in a clinical setting.

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