How Ketamine Works
Ketamine acts on NMDA receptors within the brain’s glutamate signaling system. Its effects involve several pathways associated with communication between nerve cells and synaptic plasticity—the ability of neural connections to change.
Research supports a rapid antidepressant effect in some patients, particularly those with treatment-resistant depression. Response and duration vary, and changes in neural signaling do not establish that treatment grows new brain cells, improves every aspect of cognition, or prevents neurological decline.
Conditions Considered
Treatment-Resistant Depression
We evaluate patients whose depression has persisted despite conventional treatment. For some individuals, ketamine may reduce symptoms more rapidly than standard antidepressants, although ongoing care is needed to assess and sustain improvement.
Anxiety, PTSD & Trauma-Related Symptoms
These concerns may be considered during a comprehensive assessment, particularly when they accompany depression. Evidence and suitability vary by diagnosis, with psychotherapy and established treatments remaining important parts of care.
Emotional Support During Cancer Care
For patients experiencing depression, anxiety, or trauma-related distress following a cancer diagnosis, we may consider ketamine within coordinated psychological and medical support.
Chronic Pain & Substance-Use Concerns
Selected neuropathic pain conditions and substance-use disorders require distinct evaluation and treatment planning. Ketamine’s potential role is considered individually, including its own misuse potential and the need for appropriate specialist involvement.
Cognitive Wellness
We discuss concerns about brain fog and mental fatigue during consultation, while recognizing that periodic ketamine treatment is not established as a “brain detox” or a method of preventing cognitive decline.
Preparation & Therapeutic Setting
Ketamine-Assisted Psychotherapy
Our KAP protocol includes preparatory sessions with a trained psychotherapist to explore intentions, expectations, and emotional readiness. At least two post-treatment integration sessions provide space to reflect on the experience and translate relevant insights into everyday life.
A Private Treatment Environment
Sessions take place in a peaceful room with ambient lighting, warm blankets, and relaxing music. We adjust the environment to your preferences and comfort, helping you feel supported throughout treatment.
Virtual Reality & Wavepaths Music
Our protocols may incorporate virtual reality experiences and Wavepaths adaptive music, selected during psychotherapy preparation. These elements help shape the session’s environment rather than guaranteeing increased brain responsiveness or a particular outcome.
Nutrient Pre-Infusions
Selected plans include a nutrient infusion before ketamine administration. We explain its ingredients and intended role separately, as improved ketamine responsiveness from these combinations has not been established.
Clinical Evaluation & Monitoring
Before treatment, we complete a medical evaluation, medication review, and laboratory testing as appropriate. We consider cardiovascular health, psychiatric history, substance use, and other factors that may affect suitability.
Our protocol includes physician attendance at the initial session and trained nursing monitoring during subsequent infusions. We monitor vital signs, alertness, and your response, with recovery assessment before discharge.
A ketamine infusion may last approximately 40 minutes, while the full appointment also includes preparation and recovery. Your schedule and any maintenance treatment are individualized according to clinical need and response.
Preparing for Your Appointment
Food & Drink Instructions
Our protocol requires avoiding food for at least four hours before treatment. We provide separate instructions for liquids and any adjustments needed for your medical circumstances.
Medication Instructions
We review all prescribed medications, supplements, alcohol use, and other substances before your appointment. Benzodiazepines—including Xanax, Ativan, Valium, Klonopin, and Restoril—require specific guidance because they may affect treatment and increase sedation.
Do not skip or stop a prescribed medication without instructions from our team and, when needed, your prescribing clinician.
Transportation & Recovery
A responsible adult must accompany you home after treatment. You should not drive, operate machinery, or make important decisions until the following day after restful sleep, or longer if instructed by our team.
Safety & Follow-Up
Ketamine can cause temporary changes in perception, dissociation, dizziness, nausea, sedation, and increased blood pressure. Less common but serious risks include breathing complications, while repeated exposure also requires consideration of urinary symptoms and misuse risk.
IV ketamine is used off-label for psychiatric conditions; it is distinct from FDA-approved intranasal esketamine. We explain the expected benefits, limitations, risks, and alternatives before proceeding.
Follow-up considers symptoms, daily function, emotional well-being, and the need for continued psychotherapy or other treatment, with maintenance sessions recommended according to clinical response.
