What Is Ketamine Therapy and How to Choose the Right Clinic?
As mental health treatment continues to evolve, ketamine therapy has emerged as one of the promising approaches in the field. Once known primarily as an anesthetic or club drug, ketamine is now being reexamined through a very different lens: its ability to relieve depression, anxiety, and chronic pain where conventional treatments often fall short.
Unlike traditional antidepressants, which typically require weeks to take effect, ketamine can bring noticeable improvement within days or even hours. But how exactly does it work? Who qualifies for this therapy? And what should patients expect before starting? Let’s unpack the science, the process, and the possibilities behind ketamine therapy.
What Is Ketamine Therapy?
Ketamine therapy involves medically supervised treatment with ketamine — first approved by the FDA as an anesthetic in 1970 and in 2019 for treatment-resistant depression. Administered at much lower doses than those used in anesthesia, ketamine is delivered in clinical settings under professional care to support a range of mental health conditions such as major depressive disorder, post-traumatic stress disorder, and acute suicidal crises.
There are several delivery formats: intravenous (IV) infusions remain the most common, but other forms include intramuscular (IM) injections, sublingual lozenges, and esketamine (Spravato), an FDA-approved nasal spray specifically indicated for treatment-resistant depression.
While some patients receive ketamine as part of standalone protocols, many clinics now integrate the therapy with psychotherapy, preparation, and integration work to help patients process their experiences and sustain long-term benefits.
What Can Ketamine Therapy Treat?
Originally explored for its rapid antidepressant effects, ketamine therapy is now being studied and applied across a wider range of psychiatric and chronic pain conditions:
- Treatment-Resistant Depression (TRD): The most common indication. Ketamine’s ability to alleviate depressive symptoms in people unresponsive to conventional medications is well-documented (Berman et al., 2000; Daly et al., 2019).
- Anxiety Disorders: Studies show ketamine’s capacity to dampen excessive fear responses and intrusive anxious thoughts (Glue et al., 2018).
- Post-Traumatic Stress Disorder (PTSD): Early clinical trials demonstrate significant symptom reduction following ketamine infusions (Feder et al., 2014).
- Obsessive-Compulsive Disorder (OCD): Emerging data suggest ketamine may reduce obsessive thinking patterns (Rodriguez et al., 2013).
- Chronic Pain: Complex regional pain syndrome (CRPS) and fibromyalgia are being treated with ketamine to manage persistent pain when opioids fail (Sigtermans et al., 2009).
- Suicidal Ideation: Perhaps one of ketamine’s most striking effects is its rapid ability to reduce active suicidal thoughts, often within hours (Wilkinson et al., 2018).
Importantly, while the list of potential uses grows, ketamine remains most established for treatment-resistant depression and acute suicidality.
What Are the Benefits of Ketamine Therapy?
At its core, ketamine’s primary appeal lies in how quickly it works. Over 70% of ketamine therapy patients, who have spent years trying multiple antidepressants, experience meaningful relief within just a few sessions.
This rapid effect makes it especially valuable for urgent cases, including suicidal thoughts — which ketamine can reduce quickly, with around 78% of patients showing improvement. It’s also promising for treatment-resistant anxiety, thanks to its ability to boost neuroplasticity and support brain regions affected by chronic stress.
Some patients report revisiting difficult emotions during sessions, but with reduced reactivity — allowing for emotional breakthroughs in a safe, contained space.
How Does Ketamine Therapy Work?
Ketamine acts differently from SSRIs or mood stabilizers. Rather than altering serotonin or dopamine levels directly, it blocks NMDA receptors in the brain and activates key pathways for emotional regulation and cognitive flexibility. Research shows ketamine may also quiet the Default Mode Network (DMN), a brain system associated with self-referential rumination and depressive looping thoughts.
The result is not simply chemical, but experiential. Many patients describe ketamine sessions as temporarily stepping outside of their usual mental patterns, allowing for new perspectives and reframing of entrenched beliefs.
What Does Ketamine Therapy Look Like?
A standard ketamine session doesn’t resemble typical talk therapy. Patients generally sit or recline in a quiet, controlled room. Vital signs are monitored throughout. The infusion itself lasts 40 to 60 minutes.
During the session, many patients experience a state of mild dissociation: a feeling of separation from the body, time distortion, visual imagery, or floating sensations. It’s often described as “dreamlike” but not overwhelming. Most clinics recommend that a therapist or trained guide be present to help patients process any material that may emerge.
Integration sessions afterward help individuals reflect on the experience, often drawing connections to their larger healing journey.
How to Choose a Safe Ketamine Clinic
As interest in psychedelic-assisted therapies grows, so does the need to choose a provider that prioritizes both safety and evidence-based care. Start by ensuring the clinic is operated or overseen by licensed medical professionals — ideally a psychiatrist, anesthesiologist, or physician with mental health expertise.
Look for clinics that offer a thorough medical and psychological screening before treatment begins, including an evaluation of your mental health history and any current medications. Avoid clinics that promise miracle cures or push treatment without a full consultation.
What to Pay Attention to When Choosing a Ketamine Clinic:
- Medical oversight: Licensed medical professionals (psychiatrists, physicians, or anesthesiologists) oversee or operate the clinic.
- Comprehensive screening: A full mental health and medical evaluation is conducted before any treatment begins.
- Clear treatment protocol: The clinic provides a structured, personalized plan tailored to your condition and needs.
- Safe clinical setting: Ketamine sessions are administered in a controlled medical environment with real-time supervision.
- Integration support: Pre- and post-session therapeutic support (e.g., counseling or coaching) is offered to help you process and apply your experience.
- Evidence-based care: The clinic follows current research and established clinical guidelines in its treatment approach.
- No pressure tactics: There is no push to commit to unnecessary or excessive sessions without reassessment.
- Transparent communication: Information is provided clearly and honestly, without exaggeration or unrealistic promises.
Is Ketamine Therapy Right for You?
Ketamine therapy is not suitable for everyone. It is not a first-line treatment and does not cure depression but can provide temporary symptom relief. Typically, it is considered when standard treatments have failed, including:
- Lack of lasting improvement following adequate trials of antidepressants (often multiple types and combinations), and/or ECT or TMS.
- No sustained benefits from adjunctive therapies such as group CBT or individual counseling.
For those who have exhausted traditional options, ketamine therapy represents a promising and expanding approach in mental health care. However, it requires careful assessment, professional supervision, and thoughtful integration to ensure it supports not only short-term improvement but also lasting positive change.
Candidates may include:
- Adults with treatment-resistant depression
- Individuals with PTSD, OCD, or chronic anxiety
- Chronic pain patients
- People experiencing suicidal thoughts not responsive to other treatments
Contraindications may include:
- Uncontrolled high blood pressure
- Active psychosis or schizophrenia
- Severe substance use disorders
- Pregnancy
Can Ketamine Therapy Work Effectively on Its Own?
Research shows that ketamine’s therapeutic effects can be enhanced when combined with psychological therapy. Therefore, it is recommended to offer ketamine treatment alongside appropriate psychological support.
Some therapies may work especially well with ketamine — for example, pairing ketamine with motivational enhancement therapy can boost motivation to maintain abstinence in alcohol and substance use disorders, thanks to ketamine’s ability to increase the desire to quit. Additionally, ketamine’s mystical and spiritual effects may complement and deepen mindfulness practices used in mindfulness-based therapies.
How Expensive Is Ketamine Therapy?
Cost is one of the biggest barriers to ketamine therapy. Because ketamine therapy is still largely classified as “off-label” for many psychiatric uses, insurance coverage remains limited, leaving most patients to self-pay.
“$400-$800 for a 40-60 minute infusion is reasonable”, says Dr. Megan Oxley, MD, founder of Michigan Progressive Health and a founding member of ASKP. “Any more and they are asking too much. Any less and you might want to be sure you are getting the personalized care you need at each visit to determine the best dose of ketamine for you.”
A typical protocol involves six infusions over a 2–3 week period. This schedule is designed to establish the initial therapeutic effect and stabilize mood improvements. Current research is exploring the optimal number of sessions for both durability and safety of long-term use.
How Long Does The Effect of Ketamine Therapy Last?
A randomised clinical study, published in 2019, showed that nasal ketamine, combined with regular antidepressants, helped patients maintain stable remission for up to 16 weeks. The duration of ketamine’s benefits varies:
- The dissociative effects wear off within hours.
- Mood improvements may last days to several weeks after a single infusion.
- With multiple sessions, many patients report more sustained remission.
- For some, maintenance infusions every 4–6 weeks help preserve gains.
Studies continue to explore the long-term durability of ketamine’s effects.
Does Ketamine Therapy Get You High?
In clinical doses, ketamine does produce altered states — but most patients don’t describe it as a “high” in the recreational sense. “A ketamine infusion can cause a profound dissociation from reality,” explains Dr. Peter Grinspoon, a primary care physician at Massachusetts General Hospital, instructor at Harvard Medical School, and certified health and wellness coach.
This dissociation is controlled, temporary, and carefully monitored to avoid adverse effects. Unlike recreational or unregulated ketamine use, medical ketamine therapy prioritizes patient safety, psychological preparation, and integration — minimizing the risk of misuse or dependency.
How to Know If Your Ketamine Treatment Is Being Administered Properly
A well-run ketamine session should feel safe, structured, and professionally guided. Here’s what to look for:
- You receive clear information about dosage, effects, and what to expect.
- Treatment is given in a clinical setting (IV, IM, or nasal spray) with trained staff monitoring you.
- Vital signs and mental state are observed throughout the session.
- Integration support is provided — someone helps you reflect on the experience afterward.
- You are not rushed, left alone, or pressured into more sessions without reassessment.
- Your questions are taken seriously, and communication is respectful and transparent.
If any of these are missing, consider it a red flag. Quality care means your mental and physical well-being are always the priority.
Choose the Type of Support That Matches Your Need
Malta 
FAQ
Is ketamine therapy the same as psychedelic therapy?
Not exactly. While ketamine can produce altered states of consciousness similar to psychedelics, it works through different neurological mechanisms. It’s not classified as a classic psychedelic like psilocybin or LSD, but it’s often used in a similar therapeutic context — especially for treatment-resistant conditions.
Can I drive after a ketamine session?
No. Because ketamine temporarily affects coordination, perception, and alertness, patients are advised not to drive or operate machinery for at least 24 hours after treatment. Most clinics require someone to accompany you or arrange safe transportation home.
Is ketamine therapy covered by insurance in the UK or US?
n the US, Spravato (nasal esketamine) may be covered for specific diagnoses like treatment-resistant depression. However, most other forms of ketamine therapy are considered off-label and are not usually covered by insurance. In the UK, ketamine clinics are mostly private and self-pay.
Are there side effects to ketamine therapy?
Yes, though they’re typically short-term. These may include dizziness, nausea, dissociation, blurred vision, or increased blood pressure. Most symptoms subside within a few hours. Any persistent or troubling effects should be reported to your care provider.
Can I do ketamine therapy alongside my regular antidepressants?
It depends on your current medications and medical history. Some combinations may require adjustment or supervision, especially MAOIs or high-dose benzodiazepines. Always disclose your full medication list during screening.
Is ketamine therapy addictive?
When administered in a medical setting under supervision, ketamine has a low risk of addiction. However, unsupervised or recreational use can lead to misuse. That’s why proper screening, structured protocols, and integration support are essential to safe use.
