Frequently Asked Questions About Ketamine Therapy

Can I drive home after treatment?
No. Driving or operating heavy machinery can be dangerous as the effects of the medication can last hours after treatment has stopped. Patients require a ride home after therapy.
Therapy is divided into two phases: induction and maintenance. During the induction phase, patients receive six infusions over a 2-6 week period to initiate therapeutic change. We offer flexible scheduling options to fit your needs, such as one infusion per week for six weeks or two infusions per week for three weeks, ensuring the treatment integrates seamlessly into your routine. After completing the induction phase, patients transition to the maintenance phase, where infusions are provided as needed, typically every few months or longer, depending on individual progress and symptoms. Our treatment protocols are personalized based on your response and schedule, with an emphasis on completing multiple sessions over a shorter period to maximize therapeutic benefits.
We do not prescribe oral ketamine or any other form of ketamine for at-home use.
We also offer intramuscular (IM) ketamine. IM ketamine is effective, safe, and a great option for people who have an aversion to an IV.
A referral is required for Spravato treatment. For ketamine infusions, a referral is not required. However, with your consent, we welcome open communication with your current healthcare providers to ensure a coordinated approach to your care. We carefully assess your medical and psychiatric history, including current and past medications and therapies.
Standard IV infusions are 40 minutes, although patients may stay for up to 90 minutes to allow for effects to wear off. Onset is 4 minutes, duration about 40 minutes, and expect 2-3 hours for the effects to dissipate. Intramuscular injection effects are immediate since the entire dose of ketamine is given at one time. These patients may leave when they choose although we encourage staying at least 40 minutes after injection.
We recommend fasting for three hours before therapy, as some patients have reported experiencing nausea with a full stomach. However, we encourage you to stay hydrated and drink plenty of water.
Please continue to take your medication as directed. We will thoroughly review all of your medications to ensure there are no interactions. It’s important to note that if you are using benzodiazepines or Lamictal, ketamine may not be as effective, and adjustments or increases in ketamine dosage may be required.
Research suggests that ketamine, when used as a sole treatment, can achieve response rates exceeding 70% in certain cases. Integrating psychotherapy with ketamine therapy is believed to enhance and extend these outcomes. At our clinic, we have observed an 82% response rate, and our protocol includes ketamine-assisted psychotherapy. This achievement is particularly significant for patients who have not found relief with traditional antidepressants. A notable aspect of ketamine therapy is its rapid efficacy in reducing depression symptoms, sometimes within hours of administration.
Common experiences include the sensation of floating or the sensation of watching yourself over your physical body. As a dissociative anesthetic, you may experience the so called “out of body” feeling with separation of mind and body. If you experience undesired or unpleasant sensations, the infusion can be stopped if treatment is given intravenously. However, this is not the case for oral, nasal, or intramuscular routes of administration. In this case, one must wait for the effects to wear off. A health care provider is closely monitoring you and can help if anything becomes uncomfortable such as nausea or anxiety. Additionally, our golden retriever, Eli, is usually available during your infusion for love and support.
Ketamine is administered at a sub-anesthetic dosage, with an initial dose of 0.5 mg per kilogram of body weight. The dosage may be modified or increased during subsequent infusions, or it can be maintained at the same level based on your diagnosis and response.
Currently, IV ketamine therapy is not covered by insurance. However, we offer flexible payment and financing plans to help you begin treatment right away. Additionally, we can provide superbills, which are detailed invoices with specific procedure and diagnosis codes. Upon your request, we can generate a superbill after each infusion, which you can submit to your insurance provider. While reimbursement is not guaranteed, some patients receive partial or full coverage depending on their insurance plan and provider policies.
Some experience side effects like nausea or fatigue during or after therapy, however, this is typically at higher doses. One can expect a mild elevation of blood pressure and heart rate during therapy, hence the importance of close monitoring and careful screening of patient’s medical history prior to treatment. We do have medications to treat anxiety, nausea, and changes in heart rate or blood pressure.

For IV ketamine, treatment resistance occurs in about 15–20% of patients. If you do not see mood improvement after the first six treatment sessions, we do not recommend additional treatments. 

Depression, anxiety, PTSD, pain, addiction, obsessive compulsive disorder, postpartum depression, fibromyalgia, and bipolar depression.
You are welcome to bring a friend, family member, or your therapist to your appointments for added support. They can stay with you during the infusion or wait comfortably in our private lobby. Please ensure you have arranged for someone to drive you home afterward, as it is not allowed to operate a vehicle following your treatment.
We encourage you to continue your current means of therapy, especially if they provide benefits to you. We anticipate that your current medications and therapy may work even better after ketamine. It is not uncommon for patients to taper doses or completely discontinue their medications after a series of ketamine infusions. However, please note that discontinuing medications such as antidepressants should be done under close monitoring and guidance from your prescribing physician or provider.
Ketamine therapy will not be offered to individuals with uncontrolled hypertension, unstable heart disease, significant active substance abuse, pregnancy, psychosis, schizophrenia, or severe liver disease.
IV/IM Ketamine
  • Route: IV infusion or IM injection
  • Session length: IV and IM is 40-60 mins.
  • Dosing schedule: 1–2×/week for 3–4 weeks; maintenance as needed
  • Monitoring: Vital‐sign checks during treatment
  • Onset of relief: Often within hours (peak by session 2–4)
  • Common side effects: Transient dissociation, ↑BP/HR, nausea
  • Coverage & cost: Off-label; ~$600–$800 per infusion (varies)

 

 

Spravato (Esketamine)
  • Route: Supervised nasal spray
  • Session length: 5–10 min dosing + ≥2 hr observation
  • Dosing schedule: 2×/week for 4 weeks; then 1–2×/week maintenance
  • Monitoring: BP checks before, during, after; staffed observation
  • REMS requirements: FDA REMS–certified center, provider, pharmacy
  • Onset of relief: Some response in 24 hr; full induction by week 4
  • Common side effects: Sedation, dissociation, dizziness, ↑BP
  • Coverage & cost: FDA-approved; insurance coverage more predictable but cost-share varies

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