Find a ketamine clinic you can actually check

A single intravenous infusion in the United States commonly costs between four hundred and eight hundred dollars, which puts a six-session induction course somewhere between roughly two and a half and five thousand dollars. That figure excludes the initial consultation, any psychiatric evaluation billed separately, integration therapy where it is not bundled, and the maintenance sessions that frequently follow. Asking a clinic for an annualised estimate covering the first twelve months produces a far more useful number than a per-session price.

Commercial insurance rarely reimburses intravenous ketamine for depression because administration for mood indications is off-label. The associated psychiatric evaluation is sometimes billable, and it is worth asking a clinic to identify exactly which components can be submitted. Esketamine is different: because it holds FDA approval for treatment-resistant depression, coverage is genuinely plausible, subject to prior authorisation and documented failure of previous treatments.

Ketamine has been FDA-approved as a general anaesthetic since 1970. Its use for depression and other mood indications is off-label, which is legal and routine across medicine but means it has not been through the approval process for that specific use. Esketamine, sold as Spravato, is the exception: it was approved in 2019 for treatment-resistant depression in adults alongside an oral antidepressant, in 2020 for depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behaviour, and in January 2025 as a standalone monotherapy for treatment-resistant depression.

A standard induction course is six sessions delivered over two to three weeks, though this convention comes from early trial protocols rather than from comparative research establishing that six is optimal. Some programmes offer four and some extend to eight. What happens afterwards is the less-discussed part: response is often not permanent, and many patients move onto maintenance sessions every two to six weeks. Any clinic presenting six sessions as a complete treatment without discussing maintenance has described half of what is involved.

Ketamine has a long anaesthetic safety record, and the subanaesthetic doses used for mood indications are a fraction of surgical doses. During a session, transient dissociation, nausea, and modest rises in blood pressure and heart rate are common, which is why continuous monitoring is standard. Serious risks concentrate in specific groups: uncontrolled hypertension, a personal or family history of psychosis or bipolar disorder, certain cardiac conditions, and significant substance use history all change the calculation. Long-term safety data for repeated low-dose psychiatric use is thinner than the anaesthetic safety data, and that distinction is worth holding onto.

Most people describe a sense of distance from the body, an altered perception of time, and sometimes visual distortion. It typically builds partway through an infusion and resolves within twenty to thirty minutes of the drip finishing. People who know in advance that this is expected, temporary and monitored generally find it far less alarming than those who encounter it unprepared. The infusion can be slowed or stopped if someone becomes distressed, and knowing that beforehand is itself a useful part of preparation.