What Is Ketamine Therapy? Benefits, Risks, and How It Works

In recent years, ketamine therapy has emerged as a groundbreaking treatment for individuals suffering from major depressive disorder (MDD), treatment-resistant depression (TRD), and a wide range of other mental health and chronic pain conditions. Unlike traditional antidepressants that often take weeks to show effects—if they work at all—ketamine works rapidly, sometimes within hours, offering a promising alternative for those who have struggled to find relief.

In this comprehensive guide, we explore what ketamine therapy is, how it works, its scientifically backed benefits, potential risks, and why it's being increasingly recognized as a transformative mental health tool.

What Is Ketamine?

Originally developed in the 1960s by chemist Calvin Stevens, ketamine was approved by the FDA in 1970 as a fast-acting anesthetic. It induces a dissociative state, making it ideal for surgical procedures and emergency medicine. Over time, researchers discovered ketamine’s profound impact on mood disorders, particularly in patients who had not responded to other treatments.

The World Health Organization lists ketamine as an essential medication, recognizing its critical role in both surgical and psychiatric care. Today, ketamine is administered in sub-anesthetic doses to treat conditions like depression, PTSD, anxiety, and chronic pain.

How Ketamine Therapy Works

Ketamine operates differently from conventional antidepressants, which primarily target the serotonin system. Instead, ketamine:

• Blocks NMDA receptors, part of the glutamate system, altering brain signaling and promoting rapid antidepressant effects.
• Stimulates the release of Brain-Derived Neurotrophic Factor (BDNF), which supports neuroplasticity—your brain's ability to form new connections and heal itself.
• Reopens “critical periods” for social and emotional learning, offering patients a unique opportunity to relearn healthy thought patterns.
• Exhibits neuro anti-inflammatory properties, which may contribute to its effectiveness in reducing depression and pain.

These combined effects can create a mental “reset” that helps interrupt cycles of negative thinking, rumination, and emotional pain.

What Conditions Does Ketamine Therapy Treat?

1. Depression & Treatment-Resistant Depression (TRD)

• Up to 30% of people with depression do not respond to standard antidepressants. For these individuals, ketamine offers hope.
• 71% of patients respond after a single infusion
• Remission rates exceed 50% after a series of treatments
• Effects can last weeks to months, especially when paired with psychotherapy

2. Anxiety Disorders

• Ketamine is especially useful for patients with co-occurring anxiety and depression.
• Effects often begin within hours.
• A standard six-infusion protocol can lead to a significant reduction and sometimes complete alleviation of anxiety symptoms.

3. Post-Traumatic Stress Disorder (PTSD)

• Not limited to military veterans, PTSD can affect anyone who’s experienced trauma.
• Relief can occur within 24 hours
• Some studies report up to 80% remission with six infusions

4. Suicidal Ideation

• Time is critical when someone is at risk of suicide.
• Suicidal thoughts often dissipate within 1 hour
• 63% experience full remission of suicidal ideation by day 3

5. Substance Use Disorders

• Ketamine is showing promise for alcohol, cocaine, and opioid addiction.
• Helps reduce cravings, especially when combined with therapy

6. Bipolar Disorder

• While bipolar I patients may be excluded from some protocols if having active mania, bipolar II patients have shown significant improvements in mood, sleep, and cognitive function.

7. Chronic Pain

• Ketamine helps with conditions like fibromyalgia, migraines, CRPS, and endometriosis.
• Works by reducing central sensitization and inflammation
• Promotes neural repair and can reframe pain perception

Types of Ketamine Therapy

There are several delivery methods for ketamine therapy:

Intravenous (IV) Infusions

• Most effective and well-researched
• Immediate symptom relief
• 100% bioavailability with precise dose control

Intramuscular (IM)

• Similar efficacy to IV
• Useful for those who prefer injection over IV placement

Nasal Spray - SPRAVATO® (esketamine) 

• FDA-approved for TRD
• 50-70% response rate, lower than IV
• Often covered by insurance

Oral Ketamine (At-Home Use)

• Lower bioavailability (~20%)
• Slower results; higher risk of misuse
• Not recommended without clinical oversight

Are you participating in an at-home ketamine therapy program? Make sure to read '7 Ways to Support Neuroplasticity During an At-Home Ketamine Program.'

The Ketamine Experience: What to Expect

During Treatment

• Patients may feel dissociation or enter a dreamlike state
• Some experiences are relaxing, while others can be emotional or introspective
• Trained staff monitor the process to ensure safety

After Treatment

• Patients often return to baseline within 3 hours
• No driving for 12 hours post-infusion
• Long-term effects emerge during neuroplastic recovery days later
• Many patients report renewed hope, clarity, and emotional resilience

To better understand the ketamine experience, be sure to read What Does Ketamine Feel Like?

Enhancing Outcomes

Ketamine works best when paired with integration therapy—sessions that help patients process and apply the insights gained during treatment.

At Innerbloom and other progressive clinics, Ketamine-Assisted Psychotherapy (KAP) is standard, encouraging deeper emotional healing and more durable outcomes.

Some research suggests that compounds such as magnesium and agmatine sulfate can be adjuncts for individuals receiving ketamine therapy. 

Who Should Not Use Ketamine Therapy?

While safe for most, ketamine is not suitable for everyone. Avoid if you have:

1. Severe cardiovascular disease
2. Active psychosis or schizophrenia
3. Uncontrolled hyperthyroidism
4. Pregnancy or breastfeeding
5. Severe liver impairment
6. Active substance abuse
7. Allergy to ketamine

Is Ketamine Therapy Safe?

Yes—when administered under proper medical supervision, ketamine therapy is considered safe and well-tolerated for most patients. Unlike opioids, ketamine does not suppress breathing, which significantly reduces the risk of respiratory complications during treatment.

In clinical settings, dosing is carefully controlled, and patients are monitored throughout the experience to ensure safety and comfort. A small percentage of patients may experience mild nausea, which is typically short-lived and easily managed with preventive or supportive measures.

Ketamine also has relatively minimal drug interactions compared to many psychiatric medications, and when used responsibly in a therapeutic, medical context, there is no known risk of physical addiction.

Misconceptions About Ketamine

"It’s just a party drug"

While abused recreationally, medical ketamine is safe and effective when administered by licensed professionals.

"It’s illegal"

Ketamine is FDA-approved and legal when used under medical supervision.

"It's not approved for depression"

While IV use is off-label, Spravato is FDA-approved, and off-label use is common in modern medicine.

"It’s only for the severely depressed"

While ketamine's main indication for treatment is TRD, IV ketamine is used to treat a number of psychiatric conditions such as anxiety, PTSD, biploar disorder, and chronic pain.

Ketamine and Neuroplasticity: A New Era of Healing

One of ketamine’s most promising effects is its ability to rewire the brain. It boosts neuroplasticity, allowing patients to break free from destructive thought patterns and build healthier mental frameworks.

Newy, a physician-formulated supplement, supports this process by enhancing brain health and neuroplasticity—making it an ideal companion for ketamine therapy.

Ketamine therapy is not a magic cure, but it offers real hope to those who’ve struggled with depression, anxiety, PTSD, and chronic pain. Its rapid action, safety profile, and versatility make it one of the most exciting developments in modern psychiatry.

By combining ketamine with professional therapy, lifestyle changes, and brain-boosting support like Newy, patients can experience deep, lasting healing—not just symptom relief.

References:

Abdallah, C. G., et al. Ketamine’s Mechanism of Action: A Path to Rapid‑Acting Antidepressants. International Journal of Neuropsychopharmacology, vol. 19, no. 4, 2016, pp. 1–14. doi:10.1093/ijnp/pyv094.

Yavi, Mani et al. “Ketamine treatment for depression: a review.” Discover mental health vol. 2,1 (2022): 9. doi:10.1007/s44192-022-00012-3

Reddy, A. The Role of Ketamine in Treatment‑Resistant Depression. Journal of Experimental Research and Practice, 2024. doi:10.20944/JERP/2024/00003.

Drozdz, S. J., et al. Ketamine‑Assisted Psychotherapy: A Systematic Narrative Review. Frontiers in Psychiatry, vol. 13, 2022. doi:10.3389/fpsyt.2022.9207256.

Almeida, T. M., et al. Effectiveness of Ketamine for the Treatment of Post‑Traumatic Stress Disorder. Journal of Psychiatry & Neuroscience, 2024. doi:10.1176/appi.focus.20230006.

Liu, J. J. W., et al. Ketamine in the Effective Management of Chronic Pain. Frontiers in Psychiatry, vol. 15, 2024. doi:10.3389/fpsyt.2024.1338581.

Israel, J. E. “Ketamine for the Treatment of Chronic Pain.” Pain Medicine, vol. 22, no. 1, 2021, pp. 123–32. doi:10.1093/pm/pnab162.

Costi, S., et al. Cognitive Neuroscience of Ketamine in Major Depression. Brain, vol. 148, no. 10, 2025, pp. 3496–3505. doi:10.1093/brain/awad284.

Pham, T. H., et al. “Fast‑Acting Antidepressant Activity of Ketamine.” Journal of Affective Disorders, vol. 257, 2019, pp. 127–31. doi:10.1016/j.jad.2019.06.004.

About the Author:

Dr. Ray Rivas is a medical doctor, former trauma surgeon, and the founder of Innerbloom Ketamine Therapy, a clinic dedicated to advancing mental health care through innovative treatments. With a deep passion for holistic wellness, he also leads Newy, a nootropic supplement company designed to support brain health. Drawing on decades of clinical expertise, a career focused on mental health, and personal experiences with growth and healing, Dr. Rivas is devoted to empowering individuals with the tools they need to achieve lasting mental and physical health.

Disclaimer:

The content provided on this blog and website is for educational and informational purposes only and should not be considered medical advice. Newy supplements are not intended to diagnose, treat, cure, or prevent any disease. Always consult a qualified healthcare professional before starting any new supplement, especially if you are pregnant, nursing, have a medical condition, or are taking other medications.