Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer at Lumin Health, hosted a Reddit AMA on r/TherapeuticKetamine community on March 6th, 2026\. The below blog post is a recap of one of the questions presented on that AMA, syndicated to the Lumin Health blog in the event that it answers any questions about ketamine therapy, Spravato treatment, or general concerns you may have about treatment.
[https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama\_im\_dr\_ben\_yudkoff\_psychiatrist\_cofounder/](https://www.reddit.com/r/TherapeuticKetamine/comments/1rj2blv/ama_im_dr_ben_yudkoff_psychiatrist_cofounder/)
Don’t hesitate to get in touch with us if you’re interested in learning more about ketamine for depression at Lumin Health. Thank you once again to the moderators and community members for facilitating such an engaging discussion.
JuneJabber asks:
Given that adolescents have a briefer history of evaluation and treatment than adults, how is it determined if adolescents have TRD? Or more generally, how is it determined if adolescents are good candidates for ketamine treatment?
Answer from Dr. Ben Yudkoff, Co-Founder and Chief Medical Officer of Lumin Health:
Thanks for another question, JJ. As an additional note before I dive in: we’ve written some interesting pieces about this on our website, including a patient interview with a young adult who worked with us for Spravato treatment. You can find that here: [https://www.lumin.health/ketamine-therapy-and-spravato-for-young-adults](https://www.lumin.health/ketamine-therapy-and-spravato-for-young-adults)
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The question of what constitutes treatment refractory depression is not totally defined, but, at its minimum, it is insufficient relief of two antidepressant medications given at adequate dose and duration and does not take into consideration the duration of time spent in the depressed experience or time spent in evaluation. There are more conservative definitions out there, as well, including extending the minimum threshold to meet criteria for TRD to 4 antidepressants. Some definitions include augmenting agents that are not from the antidepressant class of meds, and some include therapy. In short, there isn’t universal consensus.
Most of the clinical ketamine community uses standard definitions of TRD – i.e., the same definition of TRD in adults – when applying eligibility consideration to minors, albeit with a host of other considerations. Considerations related to consent, the implication of using a psychoactive medication to achieve improvement in a minor and what that message means to this specific demographic, the etiology of the depression, the impact of the symptoms, the system surrounding the adolescent to participate in the kiddo’s recovery, questions related to risk – all of this and more needs to be duly regarded and weighed. Minors are an intrinsically more vulnerable population and their ability to consent to and participate in treatment is treated differently. In short, while the standard definitions of TRD apply to both adults and minors commensurately, there are numerous other factors when considering eligibility and prognosticating potential success that truly separate between minors and adults.
An adolescent is more likely to be considered eligible for care when several key factors align:
- Cognitive maturity – they can understand the risks and benefits of the treatment.
- High illness burden – the risks of remaining ill clearly outweigh the potential risks of the treatment itself.
- Strong support systems – they have an environment capable of facilitating their improvement.
- Trackable symptoms – their depression aligns closely enough with standard TRD definitions so that progress can be reliably measured.
Thoughtful and challenging question. Thank you\!
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