Tiago Gil, MD

What Category Provider type are you? Anesthesia
What board certifications do you hold? Anesthesiologist
How many years have you been in ketamine practice? 3 years
What percentage of your work is clinical versus research? 1/4 of my time is dedicated to research
Please describe any connections you have to major universities, research institutions and pharmaceutical companies, both financial and advisory/board? I am an voluntary researcher at Sao Paulo University – Mood Disorder Unit at Psychiatric Institute in the field of anesthetics with anti depressive, anti suicidal and mood stabilizing proprieties. i have a clinical trial approved and waiting COVID to beging https://clinicaltrials.gov/ct2/show/NCT04171193 –
I also have been appointed to be Spravato Speaker In Brazil – waiting to formalize when regulatory agency authorize the use of Spravato in Brazil
What are your views regarding desirability and appropriateness of including and fostering the variety of practitioners who presently administer ketamine for mood disorders? I see ketamine as a revolutionary way to think and manage mood disorders. Everyone committed to alleviate suffering and bring hope are welcome. But ketamine is not a toy and the one who wants to help need to learn and follow basic safety standards. I see that this moment is to spread the word, learn, aggregate, not separate. No knowledge is useful in the hand of a few
What is your preferred route of administration of ketamine for mood disorders. What are your thoughts about the appropriateness or therapeutic value of other routes? I prefer the most studied rout, endovenous. I see the other routes as adequate routes and they have their place in the treatment. I see that they can fit somewhere between oral and endovenous routes. We may study more and more and find the best patients for each route.
How do you approach the problem of integrating the transient altered state we induce into the patient’s overall psychic economy? What is the practitioner’s responsibility in this regard? The altered state is something very powerful, personal and a fragile moment which should be cared for as is. Empathy should guide the decisions. One who decides to change someone must assume all responsibility that comes with it.
Please describe your present clinical practice. How will it look different in 5 years? I´m from Sao Paulo, Brazil and i have a private practice. I do only ketamine infusions, that´s my only income. I do ketamine in a private suit inside a hospital ( Brazilian law). Everyone goes through a screening and pre-anesthetic consultation of about 1:30h where I explain all the possibilities, risks, benefits and what to expect from the treatment and all the legal papers are signed. I keep in close contact with the patient´s psychiatrist and make some decisions with consent of the patient and psychiatrist. Infusing, safety, dosing, managing adverse events and collateral effects is on me.i stay at the room fulltime. I do about 5 patients, one at once, every day.
In five years i want to be a excellence center and a reference in ketamine administration. I´m working to make it a safe and comforting space to help people achieve their goals in mental health, using the best therapy for each one making it more precise and generating best results. The precision and responsibility with the most advanced science is what I want to be known for.
I advocate for the inclusion of ketamine for mood disorders ( we already have for pain) in the insurance coverage and to make ketamine a common place in Brazil specially in psychiatric hospitals. We have universal free heathcare and we must advocate to include ketamine in this scenario, I believe that those actions will make ketamine more accessible.
How do you envision ASKP3 growing over the next 4 years? I see ASKP3 as a reference for scientific literature, sponsoring research in the field to fill the gaps in current knowledge and working to make ketamine become on-label for psychiatric disorders and pain medicine. I will work to connect ASKP3 with other scientific  societies with a shared interest and make the ketamine practice stronger. I think ASKP3 must go overseas and connect with branches in other countries to make all the knowledge available in other languages, and help people around the world to have access to ketamine with the best evidence and best practices. American societies like American Society of Anesthesiologists and American Heart Association are reference for the world and I will work to make ASKP3 a reference as well. In four years I imagine ASKP3 publishing the first journal with original research about ketamine, publishing online material, promoting meetings and courses about ketamine in all it´s extension, in America and overseas.