Ketamine therapy is a medically supervised treatment that uses low doses of ketamine to reduce symptoms of treatment-resistant depression, anxiety, PTSD, and chronic pain. It works by influencing glutamate signaling and promoting neuroplasticity, helping the brain form new, more adaptive pathways.
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What Is Ketamine?
Let’s start with the facts. Ketamine is “a dissociative anesthetic that has some hallucinogenic effects” (Drug Enforcement Administration, 2020). Originally developed as an anesthetic, ketamine is commonly used in veterinary medicine for short-term sedation and pain relief during surgery and procedures.
Currently, ketamine is the only FDA-approved psychoactive drug available to mental health providers and their patients. It has been shown to improve symptoms of depression in individuals with treatment-resistant depression as well as rapidly reduce suicidal ideations in suicidal patients (Grunebaum et al., 2018). Ketamine may also be a promising treatment for alcohol use disorder (AUD). Individuals with AUD were able to abstain for longer with ketamine-assisted psychotherapy.
How Ketamine Works in the Brain
Ketamine affects the brain differently than traditional antidepressants. Most standard medications for depression work on the serotonin system and can take several weeks to produce noticeable changes.
Ketamine acts primarily on the glutamate system, the brain’s main excitatory neurotransmitter, by blocking NMDA receptors and increasing the release of BDNF (Brain-Derived Neurotrophic Factor).
This process promotes neuroplasticity, which is the brain’s ability to form new neural connections. In simpler terms, ketamine temporarily shifts the brain out of rigid, depressive thought patterns and opens a window where learning, emotional processing, and therapeutic change may happen more effectively. It’s not just numbing symptoms—it’s helping the brain reconnect, adapt, and respond in new ways.
What Results Should I Realistically Expect?
Ketamine therapy does not work the same way for everyone. Some people experience noticeable relief within the first few sessions, while others notice more gradual changes in mood, perspective, or emotional flexibility. The effects are often strongest when therapy and lifestyle support are included. Most people will need a series of sessions followed by occasional maintenance treatment. The goal is not to “erase” depression or anxiety overnight — it’s to create space for healing and change.
Risks & Side Effects
While ketamine therapy can be effective, it is not without risks. Common short-term side effects include dizziness, nausea, elevated blood pressure, blurred vision, fatigue, and dissociation (a temporary sense of disconnection from one’s thoughts, surroundings, or body). These effects typically resolve within one to two hours after a session.
Less commonly, ketamine can cause emotional overstimulation, anxiety during the experience, or headache afterward. Ketamine is not recommended for individuals with uncontrolled hypertension, a history of psychosis, or certain types of bipolar disorder, as it may worsen symptoms.
Who May Benefit From Ketamine Therapy
People who have:
- Treatment-resistant depression
- Severe or recurrent depressive episodes
- Suicidal thoughts needing rapid intervention
- PTSD or trauma-related symptoms
- Chronic pain conditions (e.g., CRPS, fibromyalgia)
- Anxiety disorders that have not responded to standard treatments
Who Should Avoid Ketamine Therapy
Ketamine therapy may not be appropriate for individuals with:
- Bipolar I disorder (due to risk of inducing mania)
- Active or untreated psychosis
- Uncontrolled high blood pressure or cardiovascular instability
- Current misuse of dissociative or stimulant substances
- Pregnancy or breastfeeding, unless cleared by a physician
Screening should always be thorough and individualized.
Because ketamine has misuse potential, it should only be used under medical supervision with structured follow-up and integration support. Screening, careful dosing, and monitoring are essential to ensure the therapy is both safe and effective.
Finding a Ketamine Therapy Provider
Choosing a ketamine therapy provider should involve more than locating the nearest clinic. Look for a program that offers medical supervision, clear screening procedures, and a treatment plan tailored to your history and needs. Reputable clinics will conduct a comprehensive assessment before beginning treatment, monitor your physical and psychological response during sessions, and provide integration support afterward to help you process insights and maintain progress.
| Method | How It’s Given | Where It Happens | Cost | Pros | Cons |
|---|---|---|---|---|---|
| IV Infusion | Slow, controlled drip | Clinic only | High | Most research support | Expensive; requires time on-site |
| IM Injection | Single injection | Clinic | Moderate | Fast onset; predictable | Less adjustable dose mid-session |
| Spravato (Esketamine) | Nasal spray | Clinic + monitoring | High (but may be covered) | FDA-approved; insurance may help | Must meet specific criteria |
| Lozenge/Troche | Dissolves under tongue | Clinic or at-home protocols | Lower | Flexible + accessible | Greater variation in absorption |
Ask who will be present during the dosing session, how emergencies are handled, and whether psychotherapy is included as part of the program—not just ketamine infusions alone. Be cautious of providers who market ketamine as a “miracle cure” or minimize the need for follow-up care. A trustworthy ketamine program should prioritize safety, transparency, and continuity of care, not just symptom relief.
Ketamine therapy is available in outpatient clinics and specialty mental health centers across the United States. If you’re searching locally, try “ketamine therapy near me” or ask your mental health provider for referrals.
Reflection Prompt: If you are considering ketamine therapy, what are the main symptoms or patterns you are hoping to shift? Writing your intentions down can support clarity in your treatment decisions.
Cost & Insurance Coverage
Ketamine therapy varies in cost depending on the type of treatment and setting. IV infusions typically range from $350–$900 per session, while Spravato (esketamine nasal spray) may be covered by insurance when used for treatment-resistant depression. Oral lozenges and at-home protocols are often more affordable but should still be supervised by a trained provider. It’s important to ask providers about pricing, financial policies, and whether they assist with insurance pre-authorization.
What to Expect During Treatment
Assessment: Your provider reviews medical and mental health history.
Preparation: You may set intentions or talk through emotions beforehand.
Administration: Ketamine is given via IV, IM injection, nasal spray (Spravato), or oral lozenge.
Experience: You will be awake but may feel relaxed, introspective, or detached from your surroundings.
Monitoring: A trained clinician remains present and monitors vital signs.
Integration: After the session, therapy or reflection helps apply insights to daily life.
If you’re considering ketamine therapy, it’s normal to have questions. Understanding what to expect can help you decide whether this approach feels right for you. The following FAQ offers clear, straightforward information about the treatment process, safety, benefits, and practical details. Use it as a starting point — and bring any additional questions to your provider so you can make an informed, confident decision.
Ketamine Therapy Progress Tracker Worksheet
This worksheet includes:
- Daily tracking for mood, sleep, and energy
- Space to log emotional shifts and insights
- A format that supports integration and therapeutic reflection
Clinician version:
Integration Checklist
Support for Reflecting and Applying Insights After Ketamine Sessions
After each session, consider:
- Note emotional shifts: Write down changes in mood, self-talk, or emotional patterns within 24 hours.
- Capture insights or themes: Record any images, metaphors, or realizations that felt meaningful during the session.
- Schedule an integration therapy session: Ideally within 48–72 hours to deepen the work while the brain is in a flexible state.
- Practice grounding exercises: Gentle breathwork, slow stretching, or sensory awareness to support nervous system regulation.
- Return to daily responsibilities gradually: Avoid jumping immediately into high-stress environments.
- Observe patterns over time: Notice how mood, sleep, concentration, and energy shift across multiple sessions.
- Be patient with the process: Change often occurs gradually, with cumulative sessions.
Summary
Ketamine therapy is an emerging treatment option for individuals who have not experienced enough relief from traditional approaches to depression, anxiety, PTSD, or chronic pain. By influencing the brain’s glutamate system and supporting neuroplasticity, ketamine can help reduce symptoms and create an opportunity for meaningful therapeutic change. However, it is not a stand-alone solution or a quick fix.
The most effective outcomes occur when ketamine is provided in a medically supervised setting and paired with integration therapy to support new patterns of thinking and coping.
If you’re considering ketamine therapy, take time to research providers, ask questions, and choose a program that prioritizes safety, transparency, and whole-person care.
Disclaimer: This article is for educational purposes only and is not a substitute for medical or mental health treatment. Always consult with a licensed healthcare provider before beginning ketamine therapy or changing your treatment plan.
Glossary of Key Terms
Neuroplasticity:
The brain’s ability to form new neural pathways and reorganize existing ones. Increased neuroplasticity can support emotional and cognitive change during treatment.
Glutamate:
The primary excitatory neurotransmitter in the brain. Ketamine acts on glutamate signaling, which plays a central role in mood, learning, and memory.
NMDA Receptor:
A receptor involved in neural communication. Ketamine temporarily blocks this receptor, which can lead to rapid changes in mood and perception.
Dissociation:
A temporary sense of detachment from thoughts, emotions, or surroundings. This is a common and expected part of ketamine’s therapeutic effect and usually fades shortly after treatment.
Integration Therapy:
The therapeutic process of reflecting on and applying insights gained during a ketamine session. Integration helps translate the experience into lasting emotional and behavioral change.
References
Grabski, M., McAndrew, A., Lawn, W., Marsh, B., Raymen, L., Stevens, T., Hardy, L., Warren, F., Bloomfield, M., Borissova, A., Maschauer, E., Broomby, R., Price, R., Coathup, R., Gilhooly, D., Palmer, E., Gordon-Williams, R., Hill, R., Harris, J.,Mollaahmetoglu, O. M., Curran, H.V., Brandner, B., Lingford-Hughes, A., Morgan. C. J. A. Adjunctive ketamine with relapse prevention–based psychological therapy in the treatment of alcohol use isorder. American Journal of Psychiatry, 2022; DOI: 10.1176/appi.ajp.2021.21030277
Grunebaum, M. F., Galfalvy, H. C., Choo, T.-H., Keilp, J. G., Moitra, V. K., Parris, M. S., Marver, J. E., Burke, A. K., Milak, M. S., Sublette, M. E., Oquendo, M. A., & Mann, J. J. (2018). Ketamine for rapid reduction of suicidal thoughts in major depression: A midazolam-controlled randomized clinical trial. American Journal of Psychiatry, 175(4), 327–335. https://doi.org/10.1176/appi.ajp.2017.17060647
Dore, J., Turnipseed, B., Dwyer, S., Turnipseed, A., Andries, J., Ascani, G., … Wolfson, P. (2019). Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy. Journal of Psychoactive Drugs, 51(2), 189–198. https://doi.org/10.1080/02791072.2019.1587556
Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., … Ladha, K. S. (2022). Ketamine assisted psychotherapy: A systematic narrative review of the literature. Journal of Pain Research,15, 1691–1706. https://doi.org/10.2147/JPR.S360733
Drug Enforcement Administration. (2020, June). Ketamine: Drug fact sheet. U.S. Department of Justice. https://www.dea.gov/sites/default/files/2020-06/Ketamine-2020_1.pdf
Cassie Jewell
Cassie Jewell, LPC, LSATP is a licensed clinical therapist and behavioral health clinician specializing in depression, anxiety, trauma recovery, and harm reduction. She has experience supporting individuals with treatment-resistant mental health conditions and approaches care through a trauma-informed, client-centered lens. Cassie is also a stroke survivor and mental health advocate who writes about recovery, resilience, and evidence-based approaches to healing. She created Mind Remake Project to provide accessible, practical mental health resources for individuals and clinicians.