Ketamine treatment is a rapidly acting therapeutic option used for certain mood disorders and chronic pain conditions, primarily administered in a clinical setting. The medication has been repurposed for its ability to quickly affect the brain’s glutamate system, which is believed to help regenerate damaged neural connections. The total time commitment for therapy involves three distinct phases: the duration of a single session, the intensive initial treatment period, and the long-term need for maintaining therapeutic effects.
The Duration of a Single Treatment Session
The time spent at the clinic for a single session depends heavily on the method of administration. For intravenous (IV) infusion, medication administration typically lasts 40 to 60 minutes. Patients must plan for a total of 90 to 120 minutes per infusion, which includes pre-treatment preparation and post-infusion monitoring. This observation time, often 30 minutes, ensures the patient is stable and temporary side effects, such as dizziness or mild dissociation, have subsided before discharge.
Alternatively, the FDA-approved esketamine nasal spray (Spravato) requires a longer total session time. Administration is brief, usually taking only a few minutes, but it is followed by a mandatory observation period. Patients must remain at the clinic for at least two hours for monitoring of blood pressure and dissociative symptoms. A single nasal spray session generally requires a time commitment of two to three hours from arrival to departure.
Standard Treatment Protocol: The Induction Phase
The initial, intensive period of therapy is known as the Induction Phase, and its goal is to achieve rapid and significant symptom relief. The standard protocol often involves a series of six sessions administered over a short timeframe, typically two to four weeks. The frequency during this period is often two to three times per week, which maximizes the cumulative effect of the medication. For IV infusions, a common regimen involves six treatments given every other day over a 12 to 14-day period.
For the nasal spray, the initial phase is structured as twice-weekly sessions for the first four weeks. This intensive schedule helps the medical team assess the patient’s response and find the most effective dosing. After this first month, patients may transition into an early optimization phase, typically involving once-weekly dosing for the next four weeks. The full benefits are usually realized after completing the entire initial series.
Maintaining Therapeutic Effects
Long-term effectiveness relies on a subsequent maintenance phase to sustain the initial symptom relief. The duration of therapeutic effects achieved during the induction phase varies significantly among individuals. Symptom relief often lasts between one and four weeks before a patient may feel the need for a booster session, though some maintain a positive response for several months without additional treatment.
To prevent relapse and maintain remission, patients typically transition to a schedule of periodic “booster” or maintenance sessions. The frequency of these sessions is highly personalized, depending on the patient’s diagnosis and how their body responds to the medication. Maintenance infusions may be scheduled as frequently as every two to four weeks initially, or once every four to eight weeks after the first six months.