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About Ketamine Therapy

Understanding Ketamine Therapy for Mental Health

Ketamine has become an area of significant clinical research because of the rapid antidepressant effects observed in some patients with treatment-resistant depression.

Unlike traditional antidepressants, which typically require daily dosing, ketamine operates through a distinct mechanism. Rather than taking a pill each day, patients receive ketamine through an infusion, with the timing and frequency of treatments tailored to their individual needs.

Here’s what to expect for mental disorders like depression:

The Phases of Treatment

  • Medical & Psychiatric Review With Provider (1 Hour)
  • Informed Consent
  • Preparation With Coach (1 Hour)
    • Clarifying intentions and personal goals for treatment
    • Preparing emotionally and mentally for what may arise
    • Establishing a sense of safety, trust, and readiness

The Treatment Session

  • You’ll be in a private, quiet, dimly lit room,in a comfortable recliner.
  • Monitors for blood pressure, heart rate, and blood oxygen are used.
  • A trained clinician (paramedic or nurse) and medical provider (doctor/PA/NP) is present throughout.
  • A therapist may be requested or required during your treatment.
  • IV Infusion (most common): A small needle is placed in your arm or hand for a slow, low-dose infusion over 40-60 minutes.
  • Intramuscular (IM) Injection: A shot is given, leading to a quicker onset.
  • SPRAVATO is administered in a certified healthcare setting as part of the SPRAVATO REMS program. Patients are monitored by a healthcare provider after treatment. ¹¹

During treatment, patients may experience temporary changes in perception, including dissociation. The timing, intensity and duration vary between patients. Bridgeway monitors patients during and after treatment until they meet the clinic’s discharge criteria. Sensations can include:

  • Dissociation: A feeling of being separate from your thoughts, body, or surroundings (“floating,” “expanding”).
  • Sensory Changes: Altered perception of time, space, colors, or sounds.
  • Introspection: Vivid, dream-like thoughts, memories, or metaphors may arise. It can feel deeply meaningful.
  • Emotional Release: Some experience a cathartic release of emotion. Important: The clinician is there to ensure you feel safe. The experience is generally not recreational; it can be intense, strange, or emotionally challenging, but it’s temporary.

  • During treatment, patients may experience temporary changes in perception, including dissociation. The timing, intensity and duration vary between patients. Bridgeway monitors patients during and after treatment until they meet the clinic’s discharge criteria.

  • You may feel groggy, unsteady, or “spacey” for 1-2 hours.

  • You are monitored until you are alert and stable on your feet.
  • There is no driving or making critical decisions for the the rest of the day.

Follow-up care can be an important part of an individualized treatment plan.

  • Observation & Discharge: You’ll rest in the clinic until you are safe to leave with your driver (usually within 1 hour post-infusion).
  • The “Afterglow” Window: Some patients choose to participate in therapy or integration-oriented coaching following treatment. Bridgeway can discuss how these services may fit into a broader treatment plan. Research continues to investigate the relationship between ketamine, neuroplasticity and psychotherapy.
  • Integration: We strongly recommend scheduling a coaching or therapy session 24-72 hours after your ketamine treatment. This helps you process insights and reinforce new neural pathways. Journaling, meditation, or light creative activities are also encouraged.
  • Side Effects: Common short-term effects include headache, nausea, dizziness, or fatigue. These usually resolve within hours.
  • It’s Not a Cure: Ketamine is not a cure, and duration of response varies. Some patients who respond may benefit from additional maintenance treatment, while others may not.
  • Potential for Abuse: Ketamine is a controlled substance due to its dissociative and potential for recreational use. Clinical use is closely supervised.
  • Side Effects: Can include dissociation, increased blood pressure, nausea, dizziness, and in rare cases with heavy long-term use, bladder issues.
  • Access and Cost: Treatment is often expensive and not always covered by insurance.

Is This the Right Treatment for You?

  • Standard treatments have failed
  • Your symptoms are severe and debilitating
  • You are exploring treatment options that may act differently than traditional antidepressants
  • Not a First-Line Treatment
  • Medical Supervision is Crucial
  • Potential Side Effects: Can include dissociation (“out-of-body” feelings), increased blood pressure, nausea, dizziness, and headache.
  • Contraindications: It may not be safe for individuals with certain conditions (e.g., uncontrolled high blood pressure, psychosis, certain heart conditions, active substance use disorder).
  • Timing: Response varies. Some patients experience improvement early, some later in a treatment series, and some do not experience meaningful improvement.
  • Not a Linear Path: Symptoms do not always improve in a straight line. If you experience worsening depression, increased anxiety, new or worsening suicidal thoughts, unusual behavioral changes or concerning side effects, contact your treating clinician promptly. If you are in immediate danger, call 911 or seek emergency care; for 24/7 crisis support, call or text 988. ⁹
  1. Complete Honesty: Disclose all medical/psychiatric history and any substance use.
  2. Commit to the Process: Attend all scheduled sessions and integration work.
  3. Safety: Never drive or operate machinery on treatment days. Have a support system in place.
  4. Communication: Report any concerning side effects or lack of progress to your clinician.

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Important Treatment Information:

Ketamine is FDA-approved as an anesthetic. ¹ The use of IV ketamine for depression and chronic pain is off-label and is not an FDA-approved indication for ketamine injection. Treatment is not appropriate for everyone. Potential benefits, risks, alternatives and expected outcomes should be discussed with a qualified medical provider.

FDA’s 2026 Ketalar label lists anesthesia indications, and FDA has specifically stated that ketamine itself is not FDA-approved for psychiatric disorders. (FDA Access Data)