Ketamine Therapy for Depression

If you've tried multiple antidepressants without lasting relief, ketamine may offer a different path forward. Unlike traditional antidepressants that can take 4-6 weeks to work, ketamine acts on the brain's glutamate system to promote rapid neuroplasticity — often easing depressive symptoms within 1-2 weeks. For many patients living with treatment-resistant depression, this can be a meaningful turning point. At Abrams Psychiatry & Wellness, we offer ketamine via intramuscular (IM) injection.

Frequently Asked Questions

  • Ketamine is FDA-approved as an anesthetic; its use for depression is considered off-label, meaning it is prescribed based on clinical evidence and physician judgment rather than a specific FDA-approved indication for this purpose. This is a well-established and widely practiced use in psychiatry, and your treatment will be closely monitored by your physician. Individual results vary, and ketamine therapy is not a substitute for ongoing psychiatric care.

  • At Abrams Psychiatry & Wellness, we offer ketamine via intramuscular (IM) injection. Research shows IM ketamine reaches nearly the same bloodstream availability as IV ketamine (about 93%, compared to IV's 100%), with a very similar half-life — meaning the two routes work through the body in comparable ways. Clinical studies have found no significant difference in antidepressant effectiveness between IM and IV ketamine for depression.

    • No IV line required — a quick injection rather than an inserted catheter, which many patients find more comfortable and less clinical.

    • Faster to administer — treatment can begin in seconds rather than requiring IV setup time.

    • Comparable relief — similar reductions in depressive symptoms as IV, with effects that can be felt within hours and sustained for several days after treatment.

    • A more contained, private experience — well-suited to our personalized, outpatient approach to care.

  • You may have heard of Spravato (esketamine), the FDA-approved nasal spray for treatment-resistant depression. It's worth understanding how it compares to the ketamine we offer:

    • The molecule: Ketamine used in IM/IV treatment contains both mirror-image forms of the molecule (R- and S-ketamine). Spravato contains only the S-ketamine component, isolated and delivered as a nasal spray.

    • FDA status: Spravato is FDA-approved specifically for treatment-resistant depression and for depression with suicidal thoughts. IM ketamine is FDA-approved as an anesthetic, and its use for depression is off-label — a well-established, evidence-based practice, but not one carrying an FDA-specific depression indication.

    • Effectiveness: Head-to-head research is still limited, but available evidence suggests broadly comparable benefit between the two, and some studies suggest IV/IM ketamine may act faster or more robustly, though this isn't fully settled.

    • Cost and insurance: Spravato is often covered by insurance given its FDA approval. As a private-pay practice, our ketamine treatment is offered directly to you without going through insurance, allowing for a more personalized and flexible treatment course without the constraints of prior authorization or step-therapy requirements.

  • Not necessarily. While you must be seen by a psychiatrist to have ketamine treatment here, Abrams Psychiatry does not have to be your primary psychiatrist. You will need to obtain approval from your current psychiatrist and consent to ongoing communication between your psychiatrist and Abrams Psychiatry.

  • No — Abrams Psychiatry & Wellness is a private-pay practice, and ketamine treatment is offered directly to patients without billing insurance. This allows for a more personalized approach without the constraints of prior authorization or step-therapy requirements. We provided needed documentation for you to file for reimbursement from your insurance company if that is a part of your plan.