Ketamine
Provider Summary
Primary Uses
Clinician-directed therapy used in some settings for treatment-resistant depression, certain anxiety/PTSD presentations, and other conditions per program criteria and local regulations.
Mechanism of action
NMDA receptor antagonist with downstream glutamatergic and synaptic plasticity effects; produces rapid antidepressant effects in some patients.
Pre-treatment / baseline requirements
Comprehensive medical and psychiatric screening (including substance use history, mania/psychosis screening, and suicide risk); baseline vitals; assess cardiovascular status (BP/HR), pregnancy status when applicable; medication review (benzodiazepines, stimulants, etc.); establish post-treatment escort and driving restriction plan.
Common side effects
Dissociation/perceptual changes, dizziness, nausea/vomiting, drowsiness, transient blood pressure or heart rate increases.
Serious adverse effects / key risks
Severe hypertension/tachyarrhythmia (rare with screening), emergence reactions, prolonged sedation, nausea/aspiration risk; misuse/diversion risk.
Clinical notes
ketamine is administered only under medical supervision with monitoring and is not a take-home treatment.
Referral requirements
Standard infusion referral form + drug-specific checklist
Not Covered By Insurance
Patient & Caregiver Education
What it treats
Clinician-directed therapy used in some settings for treatment-resistant depression, certain anxiety/PTSD presentations, and other conditions per program criteria and local regulations.
How it works
Affects glutamate signaling (NMDA pathway), which may improve mood symptoms in select patients.
Before treatment
tell your clinician if you have an active infection/fever, are pregnant/planning pregnancy, or have major heart/nerve problems. Depending on the medication, you may need labs or screening tests (e.g., TB/hepatitis) and a vaccine review.
Get urgent help for
Severe hypertension/tachyarrhythmia, emergence reactions, prolonged sedation, nausea/aspiration risk; misuse/diversion risk.
On treatment day
plan to stay for monitoring. Do not drive or operate any heavy machinery and follow your clinician’s instructions.
IV ketamine may be considered for adults with:
- Treatment-resistant depression
- Major depressive disorder
- Certain anxiety/PTSD symptoms (select cases)
- Other provider-directed indications
Eligibility is individualized, and ongoing mental health care is strongly recommended.
How Ketamin works (mechanism)
Ketamine is an NMDA receptor antagonist that alters glutamatergic signaling; downstream effects may influence synaptic plasticity and symptom relief in some patients. FDA Access Data+1
What to expect on infusion day
- Pre-infusion check-in: vitals, medication review, symptom screen
- IV placement and continuous monitoring during infusion
- Post-infusion observation until clinically stable
- No driving the day of treatment; arrange a responsible adult to take you home
Pre-treatment evaluation (typical requirements)
Your referring clinician (and/or our intake team) may request:
- Recent behavioral health note with diagnosis and treatment history
- Medication list, allergies, and substance use history
- Cardiovascular history and baseline vitals (BP/HR)
- Pregnancy screening when applicable
- Safety planning and follow-up plan with the treating clinician
Common side effects
- Dissociation or feeling “detached”
- Drowsiness/fatigue
- Dizziness