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. Ketamine therapy is available in outpatient clinics and specialty mental health centers across the United States. Choosing a ketamine therapy provider should involve more than locating the nearest clinic.

When someone is treated with ketamine for depression, the effects will eventually wear off. But people with bipolar disorder shouldn’t do that because ketamine, in rare cases, can trigger a manic episode. So sometimes, people skip those meds on their ketamine treatment day. Other drugs that cause glutamate release – such as benzodiazepines – can dampen ketamine’s effects. Like all drugs, ketamine can have side effects, even when used under a doctor’s supervision in a clinical setting.

What If I Have an Unpleasant Experience?

We identified six studies of ketamine treatment for social anxiety disorder and/or generalised anxiety disorder (GAD). Similar to unipolar depression, the reviews found a rapid and short-lived antidepressant effects of ketamine in patients with bipolar disorder.6,8,9,14,50,56,57 Meta-analyses identified effects with onset as early as 4 h43 and consistently by 24 h.6,9,14,50,57,58 Findings are less consistent with respect to duration, with some analyses concluding that effects are limited to 3 days14,57 and others reporting that effects retain superiority over placebo at 7 days.43,50 Meta-analyses at 14 days did not find an effect of ketamine.14,43,57,58 Ketamine is effective both in trials restricted to patients with treatment-resistant depression (i.e. non-response to prior antidepressant trials) and trials that included patients who had responded to prior treatment.6,45 Likewise, ketamine’s effect has been identified in patients who are currently taking other antidepressant medications, as well as those who are drug-free or have completed a washout period.6,41,46,49

Ketamine acts on NMDA receptors in the brain, triggering a surge in glutamate. Long-term effects and safety are under continuous evaluation, so proper clinical screening and monitoring are crucial (Rasmussen, 2024). Sessions are often paired with psychotherapy to integrate the experience for optimal outcomes (Walsh et al., 2022).

Furthermore, ketamine has been found to exist in nature, where it is produced by the fungus Pochonia chlamydosporia. A comparison of the growth patterns in the brain and in the plant kingdom demonstrates them to be remarkably similar. This protein stimulates the brain to produce greater numbers of neurons and more synapses, which are connections between these neurons.

What side effects may I notice from receiving this medication?

• Given that ketamine may also be used recreationally, it is notable that even in addiction treatment, no studies in our review report a transition to illicit use engendered by introduction to ketamine in a therapeutic context.
• Other temporary, cardiovascular side effects include palpitations, elevated blood pressure, and increased heart rate, and, for this reason, ketamine treatment is often contraindicated for individuals with serious cardiovascular conditions.
• But the drug’s potential as a treatment for depression and suicidal thoughts has drawn researchers’ attention.
• In particular, children with cyanotic heart disease and neuromuscular disorders are good candidates for ketamine anesthesia.
• Ketamine also helps restore neuroplasticity, which can reverse some of the brain changes caused by long-standing pain.
• With proper integration, ketamine therapy interventions could unlock powerful change.
• Ketamine is effective for the relief of chronic treatment-resistant pain, including neuropathic pain, complex regional pain syndrome, and fibromyalgia (Al Mukhaizeem et al., 2023; Israel et al., 2021).

“If they are unable to continue therapy, they are directed to other local resources,” he says. A full treatment course can be several thousand dollars. It also may not be safe for people who have schizophrenia because of the psychosis risk, Krystal says. Many clinical trials have barred people with substance use problems.

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We want to make mental health care accessible to everyone. Schema therapy helps people identify and meet their core needs by changing negative patterns they’ve developed in thinking what to do if you relapse about themselves and others. Rational emotive behavior therapy helps people identify irrational beliefs that inform their behavior, then replace them with more helpful beliefs. Psychedelics like LSD, ecstasy, and even magic mushrooms have been shown to offer some mental health benefits. Mindfulness-based cognitive therapy (MBCT) combines mindfulness practices with cognitive behavioral strategies to help manage depression.

Benefits and Risks of Ketamine Treatment

• Intravenous ketamine bioavailability is 100% by definition, intramuscular injection bioavailability is slightly lower at 93%, and epidural bioavailability is 77%.
• When used as an adjunct to psychotherapy, ketamine therapy can open a window for deeper therapeutic engagement that enhances emotional flexibility, meaning-making, and post-traumatic growth.
• However, other modes of administration, such as oral, intramuscular, sublingual and intranasal, which require less clinical resources, have clear practical advantages for repeated dosing and patient comfort.3,6–9
• Writing your intentions down can support clarity in your treatment decisions.
• At present, racemic ketamine is not FDA-approved for psychiatric treatment; however, it’s been used off-label for decades for psychiatric treatment, and it’s currently one of the two forms commonly used today in this capacity.
• Intravenous ketamine infusion in treatment-resistant depression may result in improved mood within 4 hours reaching the peak at 24 hours.

Group therapy is a form of counseling where a small group of people meet regularly to discuss and work on shared issues alongside a therapist. Exposure therapy helps people overcome their fears by gradually and repeatedly facing them in a controlled way. Existential therapy helps people explore issues like meaning, freedom, and mortality. Dialectical behavior therapy (DBT) helps people manage intense emotions by combining individual and group therapy with skills training and coaching.

Providing psychedelic assisted therapy with ketamine to Maine and New Hampshire communities. Not sure if you’re dealing with anxiety, depression, or both? Living with depression, psilocybe semilanceata habitat anxiety, PTSD, or another hard-to-treat condition can feel exhausting, especially if you’ve already tried other options without relief. Like ketamine, TMS avoids the systemic side effects of oral medications and doesn’t require anesthesia

The discovery of antidepressive action of ketamine in 2000 has been described as the single most important advance in the treatment of depression in more than 50 years. The more active enantiomer, esketamine (S-ketamine), is also available for medical use under the brand name Ketanest S, while the less active enantiomer, arketamine (R-ketamine), has never been marketed as an enantiopure drug for clinical use. Dissociation and psychotomimetic effects are reported in people treated with ketamine at plasma concentrations of approximately 100 to 250 ng/mL (0.42–1.1 μM). Acute inhibition of the lateral habenula, a part of the brain responsible for inhibiting the mesolimbic reward pathway and referred to as the “anti-reward center”, is another possible mechanism for ketamine’s antidepressant effects. Naltrexone potentiates psychotomimetic effects of a low dose of ketamine, while lamotrigine and nimodipine decrease them. There are case reports of increased liver enzymes involving ketamine treatment of chronic pain.

The clinician gives ketamine as an infusion through an IV (into the vein) line. Ketamine therapy—like anything in the field of medicine—has its pros and cons that need to be heavily considered before diving in. Find a team that closely monitors how you respond to the drug and ensure they have a procedure in place in case you have an adverse reaction. Ketamine can also impair cognition, perceptions, and decision-making, and in some, trigger psychosis (so it’s often a no-go in those with a history of schizophrenia or related conditions). First, ketamine can raise your blood pressure and heart rate so if you have a history of stroke, heart attack, or cardiovascular issues, you should avoid it.

In fact, up to 30% of people with depression don’t respond to SSRIs or other common medications. Ketamine therapy is still being researched and trialled with the hopes of it being rolled out as a treatment option on a wider scale. Despite this, it wasn’t until almost 3 decades later when the first randomised controlled trial demonstrating ketamine’s antidepressant effects was published by a team at Yale School of Medicine. She created Mind Remake Project to provide accessible, practical mental health resources for individuals and clinicians. Cassie is also a stroke survivor and mental health advocate who writes about recovery, resilience, and evidence-based approaches to healing.

The original form of ketamine, formally known as “racemic” ketamine, is composed of two mirror-image molecules or enantiomers, known as what drugs was eminem addicted to S(+)-ketamine and R(–)-ketamine. Ketamine gained popularity during the Vietnam War for surgical use because of its safety profile, relative to phencyclidine (PCP); however, for various reasons, its use at high doses declined over time for surgical purposes (Carillo et al., 2022; Sachdeval et al., 2023). If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Before you decide to start taking ketamine for psychiatric care, you need to know what it will involve. After the initial 6 to 8 doses (induction phase), doses usually last for 3 weeks (maintenance phase). The antidepressant effects of the initial infusions may only last 1 to 10 days.

Rapid relief of treatment-resistant depression

This research underscores ketamine’s potential to revolutionize mental health treatment by targeting underlying brain pathways that conventional medications may miss. For individuals facing conditions like depression, anxiety, OCD, or chronic pain, the journey to effective treatment can be long and frustrating. These side effects may happen in 1 out of 10 people during ketamine therapy.

Motivational interviewing is a collaborative therapy approach that helps you find your own reasons for change instead of relying on external guidance. Mindfulness-based stress reduction teaches mindfulness meditation to help people live in the moment and manage stress. Mindfulness-based cognitive therapy (MBCT) Marriage counseling is a type of couples therapy that helps married couples resolve conflicts and improve their marriage.