Introduction
Ketamine, a dissociative anesthetic first synthesized in 1962, has become one of the most significant developments in psychiatric medicine in decades. Originally used as a battlefield anesthetic during the Vietnam War and later as a veterinary and pediatric anesthetic, ketamine gained attention in the early 2000s when researchers at Yale discovered that a single sub-anesthetic dose could produce rapid antidepressant effects in patients who had failed to respond to conventional treatments.
Today, ketamine therapy is available through thousands of clinics in the United States and is used to treat treatment-resistant depression, PTSD, anxiety disorders, OCD, suicidal ideation, and certain chronic pain conditions. The FDA approved esketamine (Spravato), a nasal spray form of ketamine's S-enantiomer, for treatment-resistant depression in 2019. Meanwhile, off-label IV ketamine infusions have been available at specialized clinics since the mid-2010s.
This guide covers everything you need to know about ketamine therapy: how it works, what the experience is like, the different routes of administration, side effects, risks, costs, and practical considerations.