Nearly one-third of people treated for depression each year don’t respond to standard antidepressants (Yavi et al., 2022). Ketamine therapy is a medical treatment that uses low doses of ketamine—originally developed as an anesthetic—to rapidly reduce symptoms of treatment-resistant depression, PTSD, anxiety, and chronic pain conditions.
Understanding Ketamine as Medicine
Ketamine has been used safely in hospitals as an anesthetic for over 50 years. What makes it unique for mental health treatment is how it works differently than traditional psychiatric medications. While most antidepressants target serotonin or norepinephrine, ketamine affects glutamate, a neurotransmitter that plays a key role in mood regulation and brain plasticity (Matveychuk et al., 2020).
Traditional antidepressants typically take four to six weeks to show effects, if they work at all. Ketamine can produce noticeable improvements within hours to days after treatment. For someone experiencing severe depression or suicidal thoughts, this rapid response can be lifesaving.
Different Forms of Ketamine Treatment
Ketamine therapy isn’t one-size-fits-all. There are several delivery methods, each with specific uses and benefits.
IV ketamine involves receiving the medication through an intravenous infusion over about 40 minutes. This is the most studied form of ketamine therapy and allows for precise dosing and medical monitoring throughout treatment. We use IV ketamine at Mend The Mind because our dual board certification in both Anesthesia and Psychiatry means we can provide the highest level of safety and medical oversight during your sessions.
Ketamine troches are dissolvable tablets you take at home. These are typically used for maintenance treatment after an initial series of IV infusions. The medication is absorbed through the mucous membranes in your mouth, providing a gentler but longer-lasting effect than IV administration.
SPRAVATO® is an FDA-approved nasal spray form of esketamine, a component of ketamine with similar antidepressant effects. It’s specifically approved for treatment-resistant depression and must be administered in a healthcare setting with observation afterward. Insurance may cover SPRAVATO® since it has FDA approval for this indication.
Ketamine-assisted psychotherapy combines ketamine treatment with therapeutic support. The medication can help lower psychological defenses and create what some patients describe as a more open, receptive state for processing difficult emotions and experiences. This integrated approach addresses both the neurochemical and psychological aspects of healing.
What Happens During Treatment
A typical ketamine treatment course starts with an evaluation to determine if you’re a good candidate. We review your medical history, current medications, previous treatments you’ve tried, and your treatment goals.
For IV ketamine, the standard protocol involves six infusions over two to three weeks, usually scheduled twice weekly. You’ll recline comfortably in a private room while receiving the 40-minute infusion. Most people remain awake but relaxed during treatment. Some experience dissociation—a temporary feeling of detachment from your body or surroundings that passes within an hour or two after the infusion ends.
After the initial series, many patients transition to maintenance treatment with periodic IV infusions or ketamine troches for at-home use. Throughout treatment, we monitor your vital signs and stay with you to ensure your safety. You’ll need someone to drive you home after IV treatments.
Conditions We Treat With Ketamine
Research supports ketamine’s use for several mental health and pain conditions, though the strength of evidence varies.
Treatment-resistant depression is the most well-studied application, with response rates reaching 50-70% in clinical studies (Yavi et al., 2022). PTSD symptoms can improve rapidly with ketamine, particularly when combined with trauma-focused therapy. Chronic pain, especially neuropathic pain from nerve damage, often responds to ketamine’s effects on the nervous system.
Suicidal ideation can decrease within hours of treatment, making ketamine valuable for acute crisis situations as part of a comprehensive safety plan. Anxiety disorders, OCD, and bipolar depression also show promise with ketamine therapy, though these applications have less research support. Results vary significantly between individuals.
Safety and Side Effects
Ketamine is generally well-tolerated when administered in a medical setting at appropriate doses. The most common side effects include temporary increases in blood pressure and heart rate, mild nausea, dizziness, and dissociative feelings. These effects are closely monitored and typically resolve within an hour or two after treatment.
Serious side effects are rare under proper medical supervision. Our anesthesia background means we’re equipped to manage any complications that might arise. Ketamine does have potential for misuse, which is why treatment must occur in a clinical setting with appropriate safeguards.
Is Ketamine Right for You?
Ketamine therapy works best for people who’ve already tried standard treatments without adequate results. You might be a candidate if you’re dealing with treatment-resistant depression or PTSD, severe symptoms that interfere with daily functioning, or chronic pain that hasn’t responded to other approaches.
Certain medical conditions require evaluation before treatment, including cardiovascular issues or active substance use disorders. A thorough consultation helps determine whether ketamine is appropriate and safe for your specific situation.
Cost is a practical consideration. IV ketamine typically isn’t covered by insurance since it’s used off-label for psychiatric conditions. SPRAVATO® may be covered for FDA-approved indications. We discuss costs transparently during your initial consultation so you can make an informed decision about treatment.
Scheduling is another important factor to consider. The standard treatment protocol requires six infusions over two to three weeks—typically twice weekly appointments. Each session takes about two hours when you include preparation, the 40-minute infusion, and monitoring time afterward. You’ll need transportation home after each treatment since the medication temporarily affects coordination. For our patients in rural Montana who may be traveling from Paradise Valley or surrounding areas, this time commitment requires planning. We work with you to create a schedule that fits your life while maintaining the treatment protocol that research shows is most effective.
What Makes Our Approach Different
At Mend The Mind, we bring together expertise in both anesthesia and psychiatry—a combination that’s relatively rare in ketamine therapy. This dual training means we understand both the medical complexities of administering ketamine safely and the psychiatric nuances of treating mental health conditions. Our provider has over a decade of clinical experience in anesthesia, bringing that depth of knowledge to every ketamine session.
We serve the rural Montana communities around Livingston, Paradise Valley, and surrounding areas. Access to innovative mental health treatments can be limited in rural settings, and we’re committed to bringing evidence-based care to patients who might otherwise need to travel hours for treatment.
Our practice focuses exclusively on adults, allowing us to tailor treatment protocols and therapeutic approaches specifically to adult mental health needs rather than using one-size-fits-all approaches. We also maintain a trauma-informed approach, recognizing that many people seeking ketamine therapy have experienced trauma, even if PTSD isn’t their primary diagnosis.
FAQ Section
Q: How quickly does ketamine therapy work? A: Many patients notice some improvement within hours to days after the first infusion, though the full therapeutic effect often builds over the course of the six-infusion series. This rapid onset is one of ketamine’s key advantages over traditional antidepressants, which typically take weeks to work.
Q: How long do the benefits of ketamine therapy last? A: The duration varies significantly between individuals. Some people maintain benefits for weeks or months after a treatment series, while others need more frequent maintenance. We work with each patient to find a maintenance schedule that sustains their improvements.
Q: Does insurance cover ketamine therapy? A: IV ketamine for psychiatric conditions typically isn’t covered since it’s an off-label use. SPRAVATO®, the FDA-approved nasal spray, may be covered for treatment-resistant depression. We can provide documentation for you to submit to your insurance company for possible reimbursement.
Q: Can I continue my regular psychiatric medications during ketamine treatment? A: In most cases, yes. We typically recommend maintaining your current medication regimen during ketamine therapy. Some medications require dose adjustments, which we’ll discuss during your evaluation.
Q: What does ketamine treatment feel like? A: Experiences vary, but many people describe feeling relaxed and somewhat detached from their body during treatment. Some report visual or perceptual changes. These effects are temporary and fade within a couple hours after the infusion ends. We stay with you throughout treatment to ensure your comfort and safety.
Conclusion
Ketamine therapy offers hope for people who haven’t found relief with traditional treatments, using a well-studied medication in a new way to rapidly address treatment-resistant mental health conditions. The key is finding experienced providers who can safely administer the treatment while supporting your overall mental health goals.
If you’re struggling with treatment-resistant depression, PTSD, chronic pain, or other conditions that haven’t responded to standard approaches, ketamine therapy might offer a new path forward. At Mend The Mind, we combine anesthesia-level safety with psychiatric expertise to provide ketamine treatment in a supportive, medically supervised environment. Call (406) 220-7639 to schedule a consultation and learn whether ketamine therapy is right for you.
References
American Psychiatric Nurses Association. (2025). Ketamine Checklist. https://www.apna.org/ketamine-infusion-therapy/
Matveychuk, D., Thomas, R. K., Swainson, J., Khullar, A., MacKay, M. A., Baker, G. B., & Dursun, S. M. (2020). Ketamine as an antidepressant: Overview of its mechanisms of action and potential predictive biomarkers. Therapeutic Advances in Psychopharmacology, 10. https://journals.sagepub.com/doi/10.1177/2045125320916657
Yavi, M., Lee, H., Henter, I. D., Park, L. T., & Zarate, C. A. (2022). Ketamine treatment for depression: A review. Discover Mental Health, 2(1), 9. https://pmc.ncbi.nlm.nih.gov/articles/PMC9010394/