FAQs

Ketamine is an FDA-approved anesthetic medication that has been used in medical settings for decades. It acts primarily as an NMDA-receptor antagonist. Researchers have also studied lower, subanesthetic doses of IV ketamine for conditions including treatment-resistant depression and some chronic-pain conditions. These psychiatric and chronic-pain uses of ketamine are off-label, meaning they are not FDA-approved indications for ketamine injection.

Source: FDA — Ketalar Prescribing Information

Ketamine injection is FDA-approved as an anesthetic. IV ketamine is not FDA-approved for depression, anxiety, PTSD, or chronic pain. Physicians may prescribe FDA-approved medications for off-label uses when they determine that doing so is medically appropriate. Bridgeway discusses the off-label nature of treatment, potential benefits, risks, and alternatives as part of informed consent.

Source: FDA — Ketalar Prescribing Information

A referral from a psychiatrist is not necessarily required. An initial consultation with a Bridgeway physician is used to review your medical history, current symptoms, previous treatments, medications, and overall health to determine whether ketamine therapy may be appropriate for you. A consultation fee applies.

No. Ketamine therapy is not appropriate for everyone with depression. Treatment decisions depend on factors such as your diagnosis, treatment history, medical history, current medications, symptoms, and overall clinical assessment.

Bridgeway encourages patients to work with qualified mental-health professionals and considers ketamine therapy as part of an individualized treatment plan when medically appropriate.

Response rates vary across studies and patients. In a randomized controlled trial of a single IV ketamine infusion in treatment-resistant depression, 64% of patients receiving ketamine met response criteria at 24 hours compared with 28% receiving midazolam. Repeated-infusion studies have also demonstrated benefit in some patients, but response is not guaranteed.

Source: Murrough et al., American Journal of Psychiatry — PubMed

Research has evaluated ketamine for several psychiatric conditions, but the evidence and appropriate use vary by condition. Whether ketamine may be appropriate depends on your individual diagnosis, medical history, medications, and clinical circumstances. Your Bridgeway provider will evaluate these factors during your consultation.

The infusion itself typically takes about an hour. Additional time is needed before discharge so that your care team can monitor your recovery and ensure you meet the clinic’s discharge criteria.

The timing and degree of response vary from person to person. Some patients notice changes early in a treatment series, while others may respond later or may not experience meaningful improvement.

Your provider will monitor your symptoms and treatment response throughout the treatment series and adjust recommendations based on your individual experience.

The number and frequency of infusions vary depending on the individual and the treatment plan recommended by your provider. A series of repeated infusions is used in some clinical protocols because studies have found cumulative antidepressant effects with repeated treatment.

The optimal number and frequency of treatments are not the same for everyone. Bridgeway individualizes recommendations based on clinical response and tolerability.

Some patients who respond to treatment may receive additional maintenance infusions. The need and timing of maintenance treatment vary substantially and are determined individually.

Source: Phillips et al. — PubMed

Some patients experience temporary dissociation or changes in perception during treatment. Experiences vary and may feel neutral, pleasant, uncomfortable, or emotionally intense.

Other possible effects may include dizziness, nausea, sedation, changes in blood pressure or heart rate, and temporary changes in perception. Medical staff monitor patients during treatment and afterward according to the clinic’s discharge procedures.

Not necessarily. Ketamine can cause sedation and changes in perception, and individual responses vary. Your care team will monitor you throughout the infusion and recovery period.

Most patients experience only brief discomfort associated with placement of the IV. Other sensations during an infusion vary from person to person.

You may feel tired, dizzy, or experience temporary changes in thinking or perception following treatment. Your provider will give you specific post-treatment instructions.

Because ketamine can temporarily affect alertness, judgment, coordination, and reaction time, you should follow Bridgeway’s instructions regarding driving, operating machinery, and other activities after treatment.

No. You should not drive, operate machinery, or perform activities requiring full alertness immediately after treatment. Follow Bridgeway’s post-treatment instructions regarding when it is safe to resume these activities.

We recommend arranging for a friend, relative, or caretaker to accompany you home after treatment.

There is no way to predict in advance how long an individual response will last or whether additional treatment will be needed.

Some patients who respond to ketamine may receive additional maintenance treatment, while others may not. Your provider will evaluate your symptoms, response, side effects, and overall treatment goals when determining whether additional treatment is appropriate.

Some medications may affect ketamine treatment, its side effects, or your overall treatment plan. Tell your Bridgeway provider about all prescription medications, over-the-counter medications, and supplements you take.

Your provider will review your medications and determine whether any adjustments are appropriate.

Do not stop or change psychiatric medications without guidance from the clinician who prescribed them.

Not necessarily. Many patients continue other psychiatric medications during ketamine treatment.

Whether you should continue, change, or discontinue any medication depends on your individual circumstances. Your prescribing clinician and Bridgeway provider should determine whether any medication changes are appropriate for you.

Do not stop or taper medication without guidance from the clinician who prescribed it.

Certain medical conditions or circumstances may affect whether ketamine treatment is appropriate. Your provider will review your medical history, medications, cardiovascular health, neurological history, substance-use history, and other relevant factors during the screening process.

Pregnancy and certain uncontrolled medical conditions may require additional evaluation or may make treatment inappropriate.

Every patient is screened before treatment, and patients are medically monitored during each infusion.

Ketamine has recognized potential for abuse and misuse and is classified as a Schedule III controlled substance.

Medical screening, controlled administration, and ongoing monitoring are important parts of treatment. Patients should tell their provider about any current or previous substance-use concerns so that these factors can be considered when determining whether treatment is appropriate.

Source: FDA — Ketalar Prescribing Information

Ketamine can cause temporary perceptual changes, dissociation, dizziness, nausea, sedation, and increases in blood pressure or heart rate.

Your provider will discuss expected effects and potential risks before treatment and monitor you during each session.

Source: FDA — Ketalar Prescribing Information

Bridgeway schedules consultations and treatments by appointment. Contact our office to ask about current availability.

Bridgeway is not an emergency or crisis service. If you are in immediate danger or believe you may harm yourself or someone else, call 911 or go to the nearest emergency service ⁹. You may also call or text 988 for 24/7 crisis support in the United States.

Treatment costs depend on the treatment plan recommended after your medical evaluation. See our Cost Page for current pricing and billing information.

Some patients may be eligible for out-of-network reimbursement depending on their insurance plan. Coverage and reimbursement are determined by the patient’s insurer and are not guaranteed. Bridgeway can provide documentation for patients who wish to submit an out-of-network claim.

Financing options may also be available. Please contact Bridgeway for current payment and financing options.

You should arrange transportation home after your infusion because ketamine may temporarily affect alertness, coordination, and judgment.

A friend, relative, or caretaker may accompany you home. Follow your provider’s post-treatment instructions regarding driving and other activities.

Follow the specific eating and drinking instructions provided by your Bridgeway care team before your appointment. These instructions may vary depending on your treatment and medical circumstances.

If you have questions about fasting or hydration before your appointment, contact Bridgeway before arriving.

Wi-Fi is available in the office. Patients may bring headphones or listen to music during treatment if permitted by the care team.

We recommend minimizing phone calls, texting, or other activities during the infusion so you can remain comfortable and focused on the treatment environment.

Yes. Bridgeway’s office is designed to accommodate patients with accessibility needs. If you have specific accessibility requirements, please contact our office before your appointment so we can help make appropriate arrangements.

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