Ketamine therapy, described honestly.
Ketamine works on a different pathway from conventional antidepressants, and for some people it lifts symptoms within days rather than weeks. It is also the corner of this field where clinic quality varies the most.
Session length
40 min – 2 hours
Induction course
6 sessions over 2–3 weeks
Supervision
Always clinically monitored
Typical cost
$400–$800 per session
Infusion, injection or Spravato
IV infusion is the most common format: a slow drip over roughly 40 minutes, with blood pressure monitored throughout. Dosing is precise and can be stopped instantly.
Intramuscular dosing is quicker to administer and cheaper to run, but once given it can't be adjusted mid-session.
Spravato (esketamine) is a nasal spray with FDA approval for treatment-resistant depression, which means it's the version insurers are most likely to cover. It must be given in a certified clinic with a two-hour observation period.
Signs of a careful clinic
- A psychiatric assessment before your first dose, not just a form
- Vitals monitored by clinical staff for the whole session
- Integration therapy offered or actively referred, not treated as optional extra
- A written plan for what happens after the induction course
Reasons to be cautious
- Uncontrolled high blood pressure or significant cardiac history
- A history of psychosis, or active substance use involving dissociatives
- Clinics that sell large session packages upfront before assessing you
- No plan for maintenance — benefits commonly fade without one
Cost and coverage
Generic ketamine infusions are usually self-pay, typically $400–$800 a session, with a six-session induction course as the standard starting point. Spravato is more often covered by insurance because of its FDA approval, though prior authorisation is nearly always required. Ask any clinic what maintenance costs look like over a year — the induction price alone is rarely the real number.
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Get matchedThis page is general information, not medical advice. If you're in crisis, call or text 988 in the US.