Ketamine therapy for depression

Ketamine therapy usually means a series of low-dose ketamine infusions through an IV, given at a clinic while you're monitored. It can ease depression quickly, sometimes within hours, when other treatments haven't worked. But ketamine isn't FDA-approved for depression or any mental health condition, so it's used "off-label," practices vary between clinics, and insurance usually doesn't cover it. A typical infusion costs about $400 to $800. Spravato, a related nasal spray, is the FDA-approved option.

How does ketamine therapy work?

Ketamine has long been used as an anesthetic. At much lower doses, it can lift depression quickly. Most antidepressants work on serotonin or norepinephrine and take weeks; ketamine works on a different brain chemical, glutamate, which is involved in how brain cells form new connections. That's thought to be why it can work so fast.

Who is ketamine therapy for?

Ketamine clinics mainly treat adults with depression that hasn't improved enough after other treatments, sometimes also severe anxiety, PTSD or suicidal thoughts. It isn't a first treatment. Clinicians usually screen out people with uncontrolled high blood pressure, certain heart or blood vessel conditions, psychosis, or a recent history of substance misuse, and ask about pregnancy.

If you're not sure how much depression is affecting you, the free depression self-check takes about three minutes.

What is a ketamine infusion like?

You sit or recline while ketamine runs through an IV, usually over about 40 minutes, with your blood pressure and heart rate monitored. Many people feel detached, dreamy or "floaty," and sounds or colors can seem different; this fades soon after the infusion ends. You'll need a ride home and shouldn't drive until the next day.

A first series is often six infusions over two to three weeks. People who respond may come back for occasional "booster" infusions to keep the benefit.

Ketamine therapy vs Spravato

	Ketamine infusions	Spravato
What it is	Ketamine through an IV	Esketamine nasal spray
FDA-approved for depression	No (off-label)	Yes
Where	Ketamine or infusion clinic	Certified clinic, monitored 2+ hours
Insurance	Usually not covered	Often covered, with prior authorization

How well does ketamine therapy work?

Research shows ketamine can reduce depression quickly, often within a day, including in people who haven't responded to other treatments. The effect from a single infusion usually fades within days to weeks, which is why clinics use a series and boosters. Long-term studies are still limited.

What are the side effects and risks?

During and soon after an infusion:

• Feeling dissociated, detached or dreamy
• A rise in blood pressure and heart rate
• Nausea, dizziness or blurry vision
• Sleepiness or confusion for a short time

Ketamine can be misused, and frequent heavy use (mainly recreational) has been linked to bladder problems and memory problems. The FDA has warned about ketamine products sold for use at home, such as compounded tablets or lozenges ordered online, because of risks like sedation, high blood pressure and misuse without monitoring. If you consider ketamine, choose a clinic with medical supervision.

How much does ketamine therapy cost?

Ketamine infusions are usually paid out of pocket. Prices vary by clinic and city, but a single infusion commonly costs about $400 to $800, often plus a first consultation of around $350. A first series of six infusions often comes to about $2,400 to $4,800, and booster infusions cost the same per visit. Ask any clinic for the full cost of a series up front.

Does insurance cover ketamine therapy?

Usually not, because ketamine isn't FDA-approved for depression. Some plans pay for parts of the care, such as the first psychiatric evaluation. Spravato, the FDA-approved nasal spray, is much more likely to be covered. See how much does therapy cost for how coverage and out-of-pocket costs work.

How do I find ketamine therapy?

Look for a clinic run or overseen by a psychiatrist or anesthesiologist, with a medical evaluation before treatment and monitoring during every infusion. Ask how they decide whether ketamine is right for you, and how they coordinate with your other mental health care. If you'd rather start with an FDA-approved option, ask a psychiatrist about Spravato; our guide on how to find a psychiatrist can help.