Ketamine therapy uses carefully controlled doses of ketamine in a medically supervised setting. Although ketamine has long been used as an anesthetic, research has also shown that it can produce rapid antidepressant effects in some adults, including people whose depression has not improved with conventional treatments.
Unlike many traditional antidepressants, which primarily affect serotonin or norepinephrine, ketamine acts mainly on the brain’s glutamate system. This different mechanism may help the brain form and strengthen connections involved in mood, learning, and emotional regulation.
At Iris Medical Group, ketamine therapy is provided exclusively at our Brentwood office. Our physician-led team supervises every session in a safe, comfortable clinical environment. We do not provide treatment in patients’ homes.
Ketamine Therapy at a Glance
- What it is: A medically supervised treatment using ketamine or, in some settings, the related medication esketamine.
- How it works: It affects glutamate signaling and may support neuroplasticity, the brain’s ability to form and reorganize neural connections.
- Who may benefit: Adults with certain conditions, particularly treatment-resistant depression, after a thorough medical and psychiatric evaluation.
- How quickly it may work: Some people notice improvement within hours or days, although response and timing vary.
- Where it is provided at Iris Medical Group: Exclusively at our Brentwood, Tennessee office under direct clinical supervision.
- Important limitation: Ketamine is not appropriate for everyone, does not work for every patient, and should not replace emergency care during a mental health crisis.
How Does Ketamine Therapy Work in the Brain?
Ketamine works differently from selective serotonin reuptake inhibitors, or SSRIs, such as fluoxetine and sertraline. SSRIs mainly affect serotonin signaling. Ketamine’s antidepressant effects appear to involve glutamate, the brain’s most abundant excitatory neurotransmitter.
Researchers are still studying the full mechanism, but the process is generally understood to involve several connected effects:
- NMDA receptor activity changes. Ketamine blocks a type of glutamate receptor called the N-methyl-D-aspartate, or NMDA, receptor.
- AMPA signaling increases. This change can increase signaling through another glutamate receptor called the AMPA receptor.
- Neuroplasticity pathways are activated. Downstream effects may help brain cells form, repair, and strengthen synaptic connections.
- Mood-related brain networks may become more adaptable. These changes may help interrupt rigid patterns associated with depression and create a temporary window in which healthier emotional and behavioral patterns can develop.
The biology is more complex than a single receptor or chemical. Scientists continue to study why some patients respond strongly while others do not. The National Institutes of Health provides a useful overview of the research into ketamine’s rapid antidepressant effects.
Why Can Ketamine Work Faster Than Traditional Antidepressants?
Traditional antidepressants often require several weeks before their full effect can be assessed. Ketamine acts through a different signaling system and may change mood-related neural pathways more quickly.
A systematic review and meta-analysis found that the antidepressant effect of a single ketamine infusion could appear within hours and was strongest around 24 hours, although the effect may lessen over time without additional treatment. This does not mean everyone will feel better immediately or that ketamine is a cure. Response, degree of improvement, and duration of benefit differ from person to person.
Clinicians generally consider ketamine when standard approaches have not provided enough relief or when its potential benefits justify the risks.
Ketamine vs. Esketamine: What Is the Difference?
The terms ketamine and esketamine are sometimes used interchangeably, but they are not identical.
Ketamine contains two mirror-image forms of the same molecule. Injectable ketamine is FDA-approved as an anesthetic. When IV or intramuscular ketamine is used to treat a psychiatric condition, it is generally prescribed off-label. Off-label prescribing is a common and legal medical practice, but it means the specific psychiatric use has not received FDA approval for that formulation.
Esketamine, sold under the brand name Spravato, contains one of ketamine’s two molecular forms and is administered as a nasal spray. It is FDA-approved for treatment-resistant depression in adults, either by itself or with an oral antidepressant. It is also approved, together with an oral antidepressant, for depressive symptoms in adults with major depressive disorder who have acute suicidal ideation or behavior. The FDA label notes that Spravato has not been shown to prevent suicide or reduce suicidal ideation or behavior. Spravato is available only through a restricted safety program and must be administered and monitored in a certified healthcare setting.
The right treatment depends on your diagnosis, medical history, current medications, prior treatment response, and available clinical options. A qualified provider should explain which medication and method they are considering before treatment begins.
What Conditions May Ketamine Therapy Help?
The strongest psychiatric evidence is for depression, particularly treatment-resistant depression. This term generally describes depression that has not improved enough after adequate trials of multiple standard treatments.
A clinician may evaluate ketamine therapy in relation to:
- Treatment-resistant depression: The most established mental health use of ketamine-based treatment.
- Major depressive disorder: Ketamine or esketamine may be considered in selected adults based on diagnosis, symptom severity, prior treatment, and safety factors.
- Post-traumatic stress disorder: Research is ongoing, and use for PTSD is off-label.
- Certain anxiety disorders: Early research is promising, but ketamine is not a standard first-line treatment for anxiety.
- Some chronic pain conditions: Ketamine is used in selected pain-management settings, although dosing and treatment protocols differ from psychiatric care.
Evidence and regulatory approval are not the same. A treatment can have supporting research while still being used off-label for a particular condition. Your provider should explain the evidence, alternatives, potential benefits, and known risks as they apply to you.
Iris Medical Group also provides broader mental health treatment in Nashville and Middle Tennessee, allowing care decisions to be considered within a more complete mental health plan.
Ketamine Therapy vs. Traditional Antidepressants
| Factor | Ketamine-Based Treatment | Traditional Antidepressants |
| Primary signaling system | Mainly affects glutamate pathways | Often affects serotonin, norepinephrine, or dopamine |
| Typical onset | Some patients improve within hours or days | Often takes several weeks to assess |
| How it is given | In a supervised medical setting; method varies | Usually a daily medication taken at home |
| Common role | Often considered after other treatments have not worked | Frequently used as first-line treatment |
| FDA status | Depends on formulation and indication | Many medications are FDA-approved for specific conditions |
| Monitoring | Direct monitoring is required during treatment | Follow-up is required, but dosing is generally self-administered |
These approaches are not always mutually exclusive. Depending on the treatment and diagnosis, ketamine-based therapy may be used alongside medication management, psychotherapy, and other supportive care.
What Are the Potential Benefits of Ketamine Therapy?
Potential benefits may include:
- A faster reduction in depressive symptoms for some patients
- A different treatment pathway when conventional medications have not helped enough
- Reduced symptom burden that may make it easier to participate in therapy and daily activities
- An individualized treatment plan with direct clinical monitoring
These are possible benefits, not guaranteed outcomes. Ketamine does not work for everyone, and improvement may be partial or temporary. Maintenance treatment or continued mental health care may be recommended depending on the patient’s response.
What to Expect During Ketamine Therapy
The exact process depends on the medication, route of administration, and treatment plan. A supervised treatment visit commonly includes the following stages.
Before Treatment
Your provider reviews your medical history, psychiatric history, current medications, previous treatments, and relevant risk factors. Your provider may check your blood pressure and other vital signs. You will also receive instructions about eating, drinking, medications, transportation, and what to do after the appointment.
During Treatment
Trained clinical staff administer the medication according to your individualized plan while monitoring you. Some people experience temporary changes in perception, a floating sensation, dizziness, relaxation, or dissociation. Others notice only mild effects.
This article focuses on what the treatment is and how it works. For a detailed description of possible physical, mental, and emotional sensations during each stage of a session, read our guide to what ketamine therapy feels like.
After Treatment
You remain under observation until the clinical team determines that you are stable to leave. Because ketamine-based treatment can temporarily affect coordination, judgment, and reaction time, you must arrange for someone to drive you home and follow your provider’s restrictions. For Spravato specifically, the FDA requires monitoring for at least two hours, and patients should not drive or operate machinery until the next day after getting a full night’s sleep.
At Iris Medical Group, we provide treatment, monitoring, and recovery at our Brentwood office. Our team will explain the exact timeline and preparation instructions for the treatment being considered.
How Many Ketamine Therapy Sessions Are Needed?
There is no universal number of sessions. Treatment schedules vary based on:
- The medication and administration method
- The condition being treated
- Symptom severity and treatment history
- How the patient responds and tolerates treatment
- Whether maintenance treatment is clinically appropriate
Some protocols begin with a more frequent induction phase and then space treatments farther apart. Others may be discontinued if there is not enough benefit. Your provider should define how and when they will measure progress rather than promising a fixed result after a predetermined number of visits.
Who May Be a Candidate for Ketamine Therapy?
An evaluation may be appropriate if you are an adult who:
- Has a diagnosed condition for which ketamine-based treatment may be clinically reasonable
- Has not improved enough with conventional medication or therapy
- Can safely receive treatment in a monitored medical setting
- Understands the potential benefits, limitations, side effects, and alternatives
- Can arrange transportation and follow post-treatment restrictions
Only a qualified clinician can determine whether ketamine therapy is appropriate for you.
Who May Need to Avoid or Delay Treatment?
Ketamine-based treatment may not be appropriate, or may require additional evaluation, for people with certain medical or psychiatric conditions. These may include:
- Uncontrolled high blood pressure or significant cardiovascular disease
- Certain aneurysmal vascular conditions or a history of intracerebral hemorrhage
- A history of psychosis or active symptoms that could be worsened by treatment
- Current substance misuse or a high risk of medication misuse
- Pregnancy, plans for pregnancy, or breastfeeding
- Medication interactions or other conditions that increase sedation or respiratory risk
This is not a complete screening list. Do not stop or change any prescribed medication unless your clinician tells you to do so.
Ketamine Therapy Side Effects and Safety
Common short-term side effects can include:
- Dissociation or feeling disconnected from yourself or your surroundings
- Dizziness or lightheadedness
- Nausea or vomiting
- Sleepiness or sedation
- Temporary increases in blood pressure or heart rate
- Blurred vision or altered perception
- Headache
- Reduced coordination or slower reaction time
These effects are one reason treatment must be supervised. The clinical team can monitor vital signs, respond to symptoms, and determine when it is safe for a patient to leave. Ketamine is also a Schedule III controlled substance with the potential for misuse and dependence, so careful screening and responsible medical oversight are essential.
Long-term and repeated-use safety is still being studied. A responsible treatment plan includes ongoing assessment of benefits, side effects, function, and the need for continued care.
How Much Does Ketamine Therapy Cost, and Is It Covered by Insurance?
Cost and coverage depend on the medication, diagnosis, treatment method, number of visits, and insurance plan.
Off-label ketamine treatment is often not covered by insurance. Spravato may be covered for eligible patients who meet a plan’s medical-necessity and authorization requirements. Coverage for one service at a medical practice does not automatically mean that every ketamine-related service is covered.
Before beginning treatment, ask for:
- The cost of the consultation and each treatment visit
- The estimated number of initial visits
- What is included in the treatment fee
- Whether prior authorization is required
- Whether your specific plan is in-network
- Your estimated out-of-pocket responsibility
Contact Iris Medical Group for current pricing and benefit-verification information related to the treatment being considered.
Ketamine Therapy in Brentwood, Tennessee
Iris Medical Group provides physician-led ketamine therapy exclusively at our Brentwood office for eligible patients from Brentwood, Nashville, Franklin, and surrounding Middle Tennessee communities.
Our office-based model allows the clinical team to complete appropriate screening, administer treatment in a controlled setting, monitor patients during the session, and support recovery before discharge. It also gives patients a clear point of contact for follow-up and coordination with their broader mental health care.
If you are considering treatment, learn more about our ketamine therapy services in Brentwood or contact Iris Medical Group to request a consultation.
Key Takeaways
- Ketamine therapy is a medically supervised treatment that acts primarily on the brain’s glutamate system.
- Its psychiatric evidence is strongest for treatment-resistant depression, although other uses are still being studied.
- Ketamine and esketamine are related but distinct, with different formulations, FDA approvals, and treatment requirements.
- Some patients improve more quickly than they would with traditional antidepressants, but results are not guaranteed.
- Screening, direct monitoring, transportation, and follow-up are important parts of safe treatment.
- Iris Medical Group provides ketamine therapy only at its Brentwood office, not in patients’ homes.
Frequently Asked Questions
Is ketamine therapy FDA-approved for depression?
Injectable ketamine is FDA-approved as an anesthetic, but its use for depression is off-label. Esketamine nasal spray, sold as Spravato, is FDA-approved for specific depressive conditions in adults and must be administered in a certified healthcare setting.
How fast does ketamine therapy work?
Some patients notice improvement within hours or days, which is faster than the typical onset of many traditional antidepressants. Others improve more gradually or do not respond. Your provider should track symptoms throughout treatment.
Does ketamine therapy cure depression?
No. Ketamine may reduce symptoms, but it is not considered a cure. Benefits can fade, and patients may need additional treatments, medication management, psychotherapy, or other ongoing care.
What does ketamine therapy feel like?
Experiences vary. Some patients describe relaxation, floating, altered perception, or temporary dissociation. Others feel only mild changes. Our complete guide explains what ketamine therapy may feel like before, during, and after a session.
Is ketamine therapy safe?
Ketamine therapy has known risks and side effects, but medical screening and direct monitoring help clinicians manage those risks. Safety depends on the patient’s health, medications, dose, administration method, and treatment setting.
Can I drive after ketamine therapy?
No. Arrange transportation home and follow your treatment team’s instructions. Restrictions may differ by medication, but ketamine-based treatment can temporarily impair judgment, coordination, and reaction time.
Is ketamine therapy offered at home by Iris Medical Group?
No. Iris Medical Group provides ketamine therapy exclusively at its Brentwood office, where patients can be evaluated, treated, and monitored in a controlled clinical setting.
How do I know whether ketamine therapy is right for me?
The first step is a medical and psychiatric evaluation. Your clinician will review your diagnosis, previous treatments, medications, health history, goals, potential risks, and available alternatives before making a recommendation.
Considering Ketamine Therapy?
If depression or another condition has not improved enough with conventional treatment, ketamine therapy may be worth discussing with a qualified provider. Iris Medical Group offers consultations for eligible patients considering treatment at our Brentwood office. Our physician-led team can explain the available treatment, evaluate whether it may be appropriate, and answer questions about safety, scheduling, and cost.
Learn more about ketamine therapy at Iris Medical Group or call (615) 274-9767 to request a consultation.
Crisis support: Ketamine therapy is not a substitute for emergency care. If you or someone else is in immediate danger, call 911. If you are experiencing a suicidal or mental health crisis in the United States, call or text 988 to reach the Suicide & Crisis Lifeline.