What Is Ketamine Therapy? A Complete Guide

What is ketamine therapy?

Ketamine therapy is a medically supervised treatment that uses low, carefully controlled doses of ketamine to relieve symptoms of conditions like treatment-resistant depression, anxiety, PTSD, and certain chronic pain disorders. First approved by the FDA as an anesthetic in 1970, ketamine has been used safely in hospitals and operating rooms for more than fifty years. Over the past two decades, researchers discovered that at much lower doses than those used for anesthesia, ketamine can produce rapid, meaningful improvements in mood — often within hours to days, rather than the weeks typically required by traditional antidepressants.

That speed is what sets it apart. For people who have tried multiple medications without relief, ketamine offers a fundamentally different mechanism of action and, for many, a new path forward. At The Practice in Jacksonville's San Marco district, ketamine therapy is delivered in a calm, monitored clinical setting by an experienced medical team who tailor each treatment plan to the individual.

This guide explains what ketamine therapy is, how it works, what conditions it may help, what a session actually feels like, and how to know whether it might be right for you.

How does ketamine work?

Most traditional antidepressants — SSRIs and SNRIs — work on the brain's serotonin and norepinephrine systems, and they typically take four to six weeks to take full effect. Ketamine works on an entirely different pathway, which helps explain both its speed and its effectiveness in cases where other treatments have not worked.

Ketamine is an NMDA receptor antagonist. By temporarily blocking NMDA receptors, it triggers a surge of glutamate, the brain's most abundant excitatory neurotransmitter. That glutamate surge activates AMPA receptors and sets off a cascade of downstream signaling — including the BDNF–TrkB and mTOR pathways — that promotes synaptogenesis, the growth of new connections between neurons.

In practical terms, chronic stress and depression are associated with the loss of synaptic connections in regions of the brain such as the prefrontal cortex. Research suggests ketamine can rapidly help restore and strengthen these connections. This is often described as the brain becoming more "plastic," or adaptable — which may also create a window in which therapy and new coping patterns are especially effective. It's one reason ketamine is sometimes paired with psychotherapy for a more durable benefit.

What conditions can ketamine therapy treat?

Ketamine is most often considered when conventional treatments haven't provided enough relief. Research and clinical use support its potential across several conditions:

• Treatment-resistant depression. The most studied use. Ketamine can produce rapid reductions in depressive symptoms, including in people who have not responded to multiple antidepressants. Learn more about ketamine infusion therapy for depression.
• Anxiety. Many patients with severe or persistent anxiety report meaningful relief. See ketamine for anxiety.
• PTSD. Studies suggest ketamine may reduce the intensity of trauma-related symptoms, particularly alongside therapy. See ketamine for PTSD.
• Chronic pain. Ketamine is used for certain pain conditions including CRPS (complex regional pain syndrome), neuropathic pain, fibromyalgia, and chronic migraines. See ketamine for chronic pain.
• Suicidal thoughts. One of ketamine's most significant findings is its ability to rapidly reduce acute suicidal ideation, sometimes after a single treatment — a critical advantage when time matters.

It's important to be measured here: while the evidence is encouraging and growing, study sizes and protocols vary, and ketamine is not a cure or a fit for everyone. Whether it's appropriate for you is a clinical decision made with a provider after a thorough evaluation.

IV ketamine vs. Spravato (esketamine): what's the difference?

You may see ketamine treatment offered in two main forms. They're related but not identical.

A 2025 meta-analysis found no statistically significant difference in overall response or remission between the two by the end of acute treatment, though IV ketamine often produces faster initial improvement. The right option depends on your diagnosis, history, insurance, and goals — something the team at The Practice will review with you during your consultation.

What does a ketamine therapy session feel like?

Knowing what to expect tends to ease a lot of first-visit nerves. A typical session is calm and unhurried, in a private space designed for comfort.

After check-in, your provider reviews your plan and begins treatment while continuously monitoring your blood pressure and heart rate. Ketamine's effects usually peak within the first hour and fade within about two hours, so most of the experience is contained within a single, supervised visit.

During treatment, some people experience a sense of dissociation — a temporary, dream-like feeling of being slightly detached from your body or surroundings, or an altered sense of time. This is expected, is not harmful, and generally fades within an hour. Many patients describe it as floating, meditative, or restful. Notably, dissociation occurs in only a portion of sessions, so many people feel little or none at all. You'll be monitored by staff the entire time, and you'll arrange for someone to drive you home afterward.

Is ketamine therapy safe?

When administered in a controlled medical setting by trained clinicians, ketamine has a strong safety profile, and most people tolerate it well. Serious side effects are rare in this context.

The most common side effects are mild and short-lived, typically resolving within an hour or two of the session:

• Mild dissociation or dream-like sensations
• Dizziness or blurred vision
• Nausea
• A temporary rise in blood pressure or heart rate
• Headache

Because ketamine can briefly raise blood pressure, your vitals are monitored throughout. Ketamine isn't appropriate for everyone — certain heart conditions, uncontrolled high blood pressure, active psychosis, a history of substance misuse, or pregnancy may make it unsuitable. This is exactly what a medical evaluation is designed to determine. Ketamine therapy at The Practice is always overseen by a qualified medical team as part of comprehensive psychiatric care.

What does a course of treatment look like?

There's no one-size-fits-all protocol, but treatment is usually structured in two phases. An initial induction series of several sessions over a few weeks helps establish a response. From there, some patients move to occasional maintenance sessions to sustain the benefit over time. Your exact plan — including how ketamine is delivered, how often, and at what dose — is personalized based on your diagnosis, response, and goals.

How much does ketamine therapy cost?

Cost depends on the type of treatment and your individual plan. IV ketamine infusions are generally paid out of pocket because the compound is used off-label for mental health, with national pricing commonly ranging from a few hundred to around a thousand dollars per infusion. Spravato (esketamine), being FDA-approved, is more often covered by insurance. Because every plan is different, exact pricing and eligibility at The Practice are reviewed during your consultation, where the team can walk you through options and any insurance considerations.

Frequently asked questions