About Ketamine Therapy

What is ketamine and how does it work?

Ketamine is an FDA-approved anesthetic that, at lower doses, can rapidly relieve symptoms of depression, anxiety, PTSD, and chronic pain. It works by modulating the brain’s glutamate system and promoting synaptic growth and plasticity—essentially “rebooting” parts of the brain involved in mood and perception.

Is ketamine therapy safe?

Yes, when administered by trained professionals in a monitored setting, ketamine therapy is very safe. It has been used in clinical practice for decades and is now supported by growing research in mental health and pain management.

What is ketamine therapy used to treat

How is Ketamine Administered?

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IV Ketamine

IV ketamine infusions deliver precise dosing into the bloodstream. It allows flexible rate adjustments for optimal outcomes.
Im ketamine icon

IM Ketamine

IM ketamine delivers rapid relief via intramuscular administration. This method ensures reliable absorption and quick onset of action.
Spravato nasal spray icon

SPRAVATO® Nasal Spray

Spravato spray provides esketamine therapy in a clinic. It delivers rapid relief and is administered under strict monitoring.
Compound ketamine nasal spray icon

Compound Nasal Spray

Compound ketamine spray delivers customizable at-home dosing for truly comfortable, reliably consistent ketamine treatment.

Understanding the Difference Between IV Ketamine Infusions vs. IM Ketamine Injections

IV Ketamine Infusions: Precision and Control

IV (intravenous) ketamine infusions deliver ketamine directly into the bloodstream through a vein using a controlled pump. This method allows for precise dosage adjustment in real-time and is typically administered over a period of 40 to 60 minutes.

The slow, steady delivery helps maintain consistent blood levels of ketamine, which can be important for minimizing side effects and optimizing the therapeutic effect.

Clinicians often prefer IV infusions for patients who need carefully titrated doses or who are just beginning ketamine treatment. It also allows the care team to stop or adjust the infusion immediately if a patient has an adverse reaction.

Because of its high level of control, IV is often considered the gold standard in ketamine therapy, especially in clinical settings treating mood disorders, chronic pain, or PTSD.

Man getting iv ketamine infusion
Young black woman getting im ketamine injection

IM Ketamine Injections: Simpler and Faster

IM (intramuscular) ketamine injections involve administering the drug directly into a muscle, usually the thigh or upper arm. 

The onset of effects is rapid—typically within 5 to 10 minutes—and the entire appointment usually takes less time than an IV infusion. IM is often chosen for its simplicity, requiring less equipment and setup.

However, unlike IV infusions, IM injections do not allow for real-time adjustments. Once the dose is administered, it cannot be reversed or slowed down. 

That said, many patients tolerate IM well and find it a more convenient and less expensive option, particularly those in maintenance treatment who already know how they respond to ketamine.

Understanding the Difference Between SPRAVATO vs. Compound Ketamine Nasal Spray

What is SPRAVATO® (esketamine)?

SPRAVATO® (esketamine) is an FDA-approved intranasal formulation of the S-enantiomer of ketamine, designed for rapid absorption and onset of antidepressant effects—often within 24 hours of the first dose.

Administration occurs in a certified clinic under a REMS program, where patients self-administer the spray and are observed for at least two hours to monitor vital signs and manage side effects.

Treatment starts with twice-weekly induction sessions, then shifts to weekly or biweekly maintenance dosing alongside an oral antidepressant.

Woman holding spravato spray bottle
Pharmacist holding compound ketamine nasal spray bottle

Compounded Nasal Ketamine

Compounded Nasal Ketamine is a specially prepared nasal spray that delivers ketamine directly through the nasal passages, offering a convenient alternative to IV infusions.

It’s often used for maintenance therapy after initial in-clinic treatments or for patients who cannot access infusion centers regularly.

Although this formulation is not FDA-approved, it is prescribed by physicians and filled by compounding pharmacies under strict clinical oversight to ensure quality, dosing accuracy, and patient safety.

Contact Southern Mind and Wellness today to see if compounded nasal ketamine maintenance therapy is right for you.

What are The Key Differences between SPRAVATO® (esketamine) and Compounded Ketamine

1. Active Ingredient
  • Spravato: Esketamine (the S-enantiomer of ketamine; more potent at the NMDA receptor).
  • Compounded Ketamine: Racemic ketamine (a mix of R- and S-ketamine)
  • Spravato: FDA-approved for treatment-resistant depression and major depressive disorder with suicidal ideation (administered in conjunction with an oral antidepressant).
  • Compounded Ketamine: Not FDA-approved for depression when used intranasally; off-label use only.
    • Spravato:
        • Fixed dosing schedule.
        • Administered in-office under direct medical supervision (REMS program required).
        • Self-administered nasal spray, but under observation.
    • Compounded Ketamine:
        • Dosing is more precise and individualized.
    • Spravato:
        • Extensive safety data.
        • Requires 2-hour monitoring post-administration for BP, sedation, dissociation.
        • Prescribers and pharmacies must be certified under the REMS program.
    • Compounded Ketamine:
        • Monitoring individualized per patient per response.
    • Spravato:
          • Expensive, but often covered by insurance with prior authorization.
    • Compounded Ketamine:
          • Typically not covered by insurance.
          • $175 per treatment, compared to $375 for IV ketamine.
    • Spravato (S-ketamine):
          • More potent NMDA antagonist.
          • May have faster onset but shorter duration of antidepressant effects.
    • Compounded Ketamine (Racemic):
          • R-ketamine may provide longer-lasting effects and possibly better tolerability in some.

    Answers to Your Most Common Question About Ketamine Therapy

    Treatment Course & Expectations
    How many sessions will I need?

    Most patients start with a series of 6 infusions over 2–3 weeks, followed by maintenance treatments as needed. Nasal ketamine may be introduced after this induction phase for ongoing symptom control. Nasal ketamine can also be used in place of IV ketamine therapy with the same treatment schedule.

    How quickly will I feel relief?

    Some patients feel better within hours of their first treatment, especially those with depression or suicidal ideation. For others, it may take several sessions to notice improvement.

    What are the side effects?
    • Mild and temporary side effects may include:
    • Dizziness or lightheadedness
    • Nausea
    • Dissociation (a dreamlike or “out of body” feeling)
    • Increased blood pressure during treatment

    These effects usually subside shortly after the session ends.  Our medical professionals will monitor you throughout your treatment and treat these side effects if they were to occur.

    Is ketamine addictive?

    Ketamine can be misused recreationally, but in a clinical setting under controlled doses and medical supervision, the risk of dependence is low.

    Is ketamine therapy covered by insurance?

    Most insurance plans do not cover ketamine for mood disorders, as it is considered an “off-label” use. We can provide superbills for possible out-of-network reimbursement.

    How much does treatment cost?

    Prices vary depending on the route of administration and the condition being treated. An IV mood infusion is $375 while an IV pain infusion is $675.  A compounded nasal ketamine administration is $175.  

    Do I need someone to drive me home?

    Yes. You should not drive or operate machinery for the rest of the day after your treatment.

    Can I eat before treatment?

    We recommend avoiding food for at least 4 hours and liquids for 2 hours prior to your session to reduce nausea risk.

    Learn More About This Innovative
    New Treatment Option

    You can be one step closer to finding the relief you are looking for. Dealing with the symptoms of depression, PTSD, OCD, anxiety, and chronic pain can be hard. Starting today, it doesn’t have to be. Request more information and learn if ketamine treatment is right for you. The information and consultation are free. There is hope. We can help.