Ketamine, with a therapist in the room.

Ketamine has been used in anesthesia for more than 50 years. At the lower doses used in therapy, with careful screening and monitoring, it’s generally well tolerated. The most common effects are temporary and fade the same day: feeling detached or dreamlike, nausea, dizziness, and a rise in blood pressure during the session.

The more serious risks linked to ketamine, like bladder problems and dependence, are mainly seen with frequent, heavy, unsupervised use, not a short, monitored course like this one. That’s why I screen everyone myself, check your vital signs, stay with you for every session, and keep all dosing in my office.

Ketamine is FDA-approved as an anesthetic. Using it for depression, anxiety, trauma or OCD is off-label. That’s common and legal in medicine, and it’s how ketamine is used in most mental health settings. The only FDA-approved form for depression is esketamine (Spravato), a nasal spray, which isn’t what I use.

This is the most common worry, and it’s one of the main reasons I’m in the room with you. The effects are time-limited, and you’re never alone with them. Much of our preparation is about how to meet whatever comes up, including the hard parts. Difficult moments are often where the most useful work happens.

You won’t be unconscious. These doses are well below what’s used for anesthesia, and you keep breathing on your own. Your sense of your body, time and surroundings can shift quite a bit, and at the peak you may not feel like talking. Letting go a little is part of the process, and I’m there the whole time. The strongest effects ease within an hour or so.

Ketamine can be misused, which is why it’s a controlled substance. In this program the risk is kept low by design: a limited number of sessions, every dose taken in my office, and nothing sent home with you. If you have a history with substances, we’ll talk it through honestly before starting.

Usually not. Most antidepressants can be continued. A few medications, such as benzodiazepines and some mood stabilizers, can blunt ketamine’s effect, so I’ll review everything you take during screening and we’ll make a plan together. Please don’t change a medication on your own to prepare.

For some people, yes. Careful tapering is a core part of my practice, and some of my clients have reduced their medications after ketamine-assisted therapy. It’s a goal we can plan toward, not a promise, and any taper happens on its own careful timeline.

Spravato and infusion clinics focus on the medicine. With me, the medicine sits inside a therapy process: preparation before, me beside you during, and integration after. I handle both the prescribing and the therapy, so nothing gets lost between providers.

You’ll need someone to drive you. Plan not to drive, work or make big decisions for the rest of that day. Most people go home and rest.

The full program is $2,750. You can pay in full or use a three-month payment plan of $960 a month, which includes a small processing fee. I accept HSA and FSA cards. I’m a self-pay practice and don’t bill insurance directly, but I can give you a superbill to submit to your insurer for possible out-of-network reimbursement. Coverage varies by plan, so it’s worth calling them first. If you need additional sessions after the program, we’ll talk about it together first.

I check in on how you’re doing throughout the program, not just at the end. If it isn’t helping, we’ll talk about it honestly and adjust, or look at other options. You can stop at any point. If you stop early, unused dosing sessions are refunded on a prorated basis.

It’s a 15-minute call. You tell me what’s going on and what you’ve tried. I’ll tell you honestly whether ketamine-assisted therapy makes sense for you, answer your questions, and explain next steps. There’s no charge and no obligation.