Ketamine is quickly gaining attention as an effective mental health treatment, especially for people who haven’t found relief with traditional medications. Originally developed as an anesthetic, ketamine is now used in carefully monitored medical settings to help treat depression, anxiety, trauma, and other mental health conditions.
Ketamine treatment has shown promise for people with treatment-resistant depression, with studies demonstrating meaningful reductions in depressive symptoms. Unlike standard antidepressants, ketamine works quickly and targets different brain pathways, offering hope for those who feel stuck despite trying other treatments.
What is ketamine therapy?
Ketamine therapy involves administering low, controlled doses of ketamine under medical supervision to help reduce symptoms of depression and other conditions. These doses are much lower than those used for anesthesia and are designed to support mental health treatment rather than sedation.
Pacific Mind Health currently provides intranasal and sublingual ketamine as well as ketamine-assisted therapy and Spravato® (esketamine), a form of ketamine specifically formulated for approval by the US Food and Drug Administration (FDA).
Ketamine can also be administered through intravenous (IV) infusions and intramuscular (IM) injections. Each method has different protocols, settings, and levels of medical oversight.
Unlike Spravato, ketamine therapy is not approved by the FDA, however, it is most commonly used off-label for:
- Major depressive disorder
- Treatment-resistant depression
- Anxiety
- Bipolar depression
- Chronic pain conditions
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Borderline personality disorder
- Addiction and substance use disorders
How ketamine treatment works
Ketamine works differently from most antidepressants. Rather than targeting serotonin, it blocks NMDA receptors in the brain, which affects the glutamate system, an important pathway involved in learning, mood, and emotional regulation.
This process increases glutamate activity and promotes the release of brain-derived neurotrophic factor (BDNF), which supports neuroplasticity. In simpler terms, ketamine helps the brain form new connections and become more flexible.
Because of this mechanism, ketamine’s antidepressant effects can begin within hours or days, rather than weeks. This rapid onset is one reason ketamine is often considered for people experiencing severe or persistent symptoms.
Ketamine infusion therapy routes and protocols
Ketamine can be delivered in a variety of ways, depending on patient preference and treatment goals. These include:
Intranasal ketamine: A nasal spray form of ketamine that is prescribed by a clinician and typically administered with medical oversight
Sublingual ketamine: Dissolves under the tongue. It is sometimes used in structured treatment programs
Ketamine-assisted therapy: Combines sublingual ketamine treatment with psychotherapy to support emotional processing and long-term change
IV ketamine infusions: Administered slowly through a vein in a medical clinic. Sessions typically last 40–60 minutes, with monitoring before, during, and after treatment.
IM ketamine: Delivers ketamine directly into a muscle
Most treatment plans include induction, optimization, and maintenance phases. After an 8-session induction phase, treatment is then typically spaced out and adjusted according to each patient’s needs.
Safety, side effects, and risks
Medical screening is essential before treatment, and patients are closely monitored during sessions.
Common short-term side effects during treatment can include:
- Dizziness
- Nausea
- Changes in perception
- Temporary dissociation
Ketamine is not recommended for people with uncontrolled high blood pressure, certain heart conditions, or active substance use disorders without careful evaluation.
Who is a candidate for ketamine treatment?
Good candidates are adults who typically:
- Have moderate to severe depression
- Have not responded to at least two antidepressants
- Can participate in medical and psychiatric screening
Some conditions require extra clearance or coordination. Complex cases benefit from a multidisciplinary care team.
What to expect during ketamine treatment
Most clinics begin with an intake assessment, informed consent, and medical review. On treatment days, patients receive ketamine in a calm, supervised setting. They are encouraged to listen to music or journal and are provided with comfort items as needed.
Patients remain under supervision for at least two hours until the effects of treatment fade. After treatment, patients must arrange transportation home and are encouraged to rest.
Conclusion
Ketamine has changed the conversation around depression treatment by offering a faster-acting option for people who haven’t found relief with traditional medications or therapy alone.
While it isn’t the right fit for everyone, growing research shows that ketamine-based treatments administered in a clinical setting can provide meaningful symptom relief and open the door to healing when other approaches have fallen short.
For anyone feeling stuck, overwhelmed, or discouraged, talking with a qualified mental health provider about ketamine therapy may be an important next step toward finding steadier ground and renewed hope.
Frequently asked questions
Is ketamine the same as Spravato?
No. Spravato is a nasal spray derived from ketamine and is FDA-approved for depression. Ketamine infusions use the original form and are prescribed off-label.
How quickly does ketamine work?
Some people notice improvement within hours or days, though responses vary.
Is ketamine addictive?
When used medically and monitored, ketamine has a low risk of misuse. Screening is important.
Can I work the same day?
Most people take the rest of the day off and return to normal activities the next day.
Key takeaways
- Ketamine is a fast-acting treatment option for depression and other conditions.
- It works through the brain’s glutamate system, not serotonin.
- Multiple forms exist, including IV infusions and Spravato nasal spray.
- Medical screening and monitoring are essential for safety.
- Ketamine is not a cure, but it can be a powerful tool when part of a comprehensive care plan.
Looking for Spravato or ketamine treatment near you?
Pacific Mind Health offers Spravato (esketamine) and ketamine therapy for treatment-resistant depression, major depressive disorder, and more. Our experienced clinicians provide compassionate, evidence-based care to help you feel better.
Ready to take the next step? Schedule a free consultation today to see if Spravato or ketamine is right for you.
