Ketamine Therapy FAQs

Ketamine was developed over 50 years ago and has primarily been used as anesthesia for surgery in children, adults, and animals. It is one of the most widely used anesthetic agents in the world due to its strong safety profile. More recently, it has been discovered to be highly effective in treating depression, anxiety, pain disorders, and more. Unlike traditional antidepressants, which can take weeks to produce results, ketamine often works within hours to days, making it a promising option for those who have not found relief through other treatments.

Ketamine infusions are effective for 70–75% of individuals, making it one of the most successful treatments available for treatment-resistant depression and other mood disorders. Many patients report significant improvement after just a few sessions. Results can vary depending on the condition being treated, the number of infusions received, and individual patient factors. Learn more about the benefits of ketamine therapy here.

No, a referral from your primary care physician is not required. However, we do ask that you obtain a referral from a licensed mental health professional prior to beginning treatment. This helps ensure that ketamine therapy is the right fit for your needs and that your care is coordinated across your providers.

Depression, anxiety, pain, and other forms of stress and mental illness damage the communication system between the areas of the brain responsible for memory, learning, and higher-order thinking. Over time, this damage can make it increasingly difficult for the brain to regulate mood, process emotions, and respond to traditional treatments.

Ketamine works by blocking NMDA receptors in the brain, which triggers a rapid increase in glutamate—a neurotransmitter that plays a key role in neural communication. This surge in glutamate promotes the growth of new neural connections, essentially helping the brain “rewire” itself. Ketamine therapy repairs the damage in these communication systems within mere hours, far faster than conventional antidepressants or therapies.

This rapid restoration of neural pathways is why many patients experience relief from symptoms almost immediately after treatment, even after years of struggling with conditions that have not responded to other interventions.

Ketamine infusions are effective treatments for severe depression, bipolar depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), pain syndromes and addiction. At Ketamine Greater Boston, we focus on using ketamine infusion therapy to treat patients with severe depression and bipolar depression.

Ketamine infusion therapy is not recommended for individuals diagnosed with or suffering from any of the following disorders: epilepsy, seizures, schizophrenia, or other types of psychosis. If you have been diagnosed with any other severe medical problem (i.e. high blood pressure, cardiac or pulmonary issues, etc.) please work with your primary care physician to stabilize these conditions prior to beginning your ketamine infusions. In some circumstances, depending on your medical history, we may require written clearance from your primary care physician prior to beginning treatment. Adverse drug interactions have been recorded with aminophylline, a brochodilator used to treat asthma and other lung diseases. If you are on other prescription or over-the-counter medications, please talk to us about potential contraindications.

For five hours prior to your ketamine infusion, please avoid the following: solid foods, orange or pulp-filled juices, or opaque soups/broths. Clear liquids (i.e. water, clear broths, apple or white grape juice, some teas, etc.) may be enjoyed up until two hours before your infusion. Avoid alcohol, drugs and other narcotics. These substances are extremely dangerous in combination with ketamine infusions. If you believe you have a problem with drug or alcohol abuse, please contact us or your mental health practitioner.

Learn more about preparing for your session by reading our blog on setting intentions for ketamine therapy, or contact our office before your session to confirm preparation instructions.

The side effects of your ketamine infusion generally wear off after two hours. However, we ask that you please refrain from driving or operating heavy machinery for 24-hours post infusion. Please arrive at your appointment with a friend or family member who can drive you home afterwards. We will not discharge you from our ketamine clinic without a driver.

Ketamine is administered intravenously very slowly over 40 minutes. The first 20 minutes of your infusion will have no noticeable effects. At around 20 minutes, you may notice blurred or double vision, a feeling of “lightness” or “floating,” and sometimes numbness in the toes or area around your mouth. During the final 20 minutes of the infusion, these feelings tend to build; the medicine is at the peak of its intensity at the very end of your treatment. Other common feelings include euphoria, talkativeness, a feeling of being in a dream-like state, heightened senses, and a feeling that people often describe as “weird, odd, different, or interesting.” Less commonly, people may experience anxiety, headache, nausea, or sweating.  These feelings will subside 10-15 minutes post-treatment.

Learn more about preparing for your session by reading our blog on setting intentions for ketamine therapy, or contact our office before your session to confirm preparation instructions.

Prior to your first treatment, we will ask you to rank various aspects of your depression. We will then ask you to rank those same aspects 24-hours after your infusion. This will help us determine how effective the treatment was. It is possible to notice positive effects as soon as 40 minutes after your infusion, or as long as 24 hours later. Most effects, however, typically start 2-4 hours post-treatment. You won’t wake up suddenly feeling perfectly overjoyed and boisterous, but rather more hopeful and less sad, with decreased thoughts of suicide, increased calmness, and more willingness to engage with people. Further improvements are often seen over the course of treatment.

A single infusion typically lasts anywhere from 2-14 days.  A series of six infusions can last anywhere from weeks to months, and often a single booster infusion taken as the effects are wearing off can restore your brain’s response. For those who have not suffered from long-standing chronic depression, the effects of your ketamine infusion may last much longer. 

You will know whether ketamine infusions are right for you after only one or two treatments. If you are responding positively, experts recommend six infusions within the first two weeks. After that, you should schedule maintenance infusions to maintain your brain’s response. The total length of treatment depends on each individual’s unique circumstances.

Eating well, exercising, engaging in talk therapy, finding social support and staying busy are generally recommended in tandem with other treatments for depression. Of course, those things are all easier said than done; depressive symptoms oftentimes prevent individuals from following these suggestions. Your ketamine infusions will enable you to act on these important activities. Ketamine changes the communication pathways in your brain, allowing you to learn more easily and make new connections. Those of our patients who capitalize on this unique window of time and pursue healthier diets, exercise regimens and social habits tend to experience the most positive results.

Talk therapy can be an ideal way to “lock in” the effects of your ketamine infusions, as your brain is in a unique position where it is open to changing neuropathways. People should continue working with their outpatient psychiatrist or primary care physician, and are highly encouraged to either begin or continue speaking with a qualified therapist. Ketamine Greater Boston is happy to refer you to our network of trusted local therapists.

Antidepressants take anywhere from weeks to months to have any effect. There are many to choose from, and yet no reliable way to know whether a certain medication will be effective and/or tolerated. A patient may wait several weeks just to find that the medicine does not work. Common side effects of antidepressants include weight gain, sexual dysfunction, gastrointestinal disturbances, sleep disturbance, fatigue, emotional blunting, and even diabetes. While not everyone responds positively to ketamine, you will know almost immediately whether the treatments are effective for you, saving you time and money in the long run. Side effects have only been observed during the physical infusion, with no side effects being observed or reported in between treatments.

There are very few medicines that can negatively impact the effectiveness of your ketamine infusions. Benzodiazepines, such as Xanax, Ativan, Valium, or Klonopin, may interfere with your brain’s response, and amphetamine-based stimulants, such as Adderall or Ritalin, should not be taken on the day of treatment.

Ketamine does not meet criteria for being physically addictive, though tolerance to its effects may occur with prolonged exposure. If abused, it may pose the risk of being a psychologically addictive substance.

Each ketamine infusion costs $600. Health insurance does not cover this fee.