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Ketamine for depression and anxiety: what to know

Worth understanding, with the medical decisions in licensed hands.

General education, not medical advice. Treatment decisions belong to licensed medical providers.

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What research suggests

  • Ketamine is a fast-acting prescription anesthetic and controlled substance, given under medical supervision. 1,2
  • It may help some people with depression, especially when other treatments haven't worked. It's also used off-label for anxiety. 1
  • Some people notice changes within hours, but effects can fade within days or weeks. Results vary. 1
  • Common side effects include feeling detached, nausea, restlessness, blurred vision, and higher blood pressure; serious ones are rare. 1
  • Long-term safety for mental health conditions is still being studied. 1

A summary of the sources below, not a prediction for you.

FDA status

Ketamine vs. esketamine (Spravato)

Off-label

Ketamine

FDA status
Approved as an anesthetic; off-label for depression and anxiety. 1
How it's given
IM injection, IV infusion, or oral and sublingual forms. Your provider decides. 2,1
Safety note
The FDA has cautioned about compounded ketamine for psychiatric use without monitoring. 4
FDA-approved

Esketamine (Spravato)

FDA status
A nasal spray approved for treatment-resistant depression in adults. 3
How it's given
Self-administered under observation in a certified healthcare setting; it can't go home. 3
Safety note
Patients are monitored after each dose and need a safe ride home. 3,1

Who decides

A licensed provider, after screening.

A licensed provider reviews your health history and medications and decides whether ketamine is appropriate. It isn't right for everyone. 1

Cleveland Clinic notes providers may suggest other options for people with, for example, a history of psychosis or substance use disorder, unmanaged high blood pressure, or certain heart or liver conditions, and to talk with a provider if you're pregnant or breastfeeding. 1 Don't rule yourself in or out; ask a provider. Ketamine doesn't replace your ongoing care.

In Denver and Colorado

Questions to ask any Denver-area provider.

  • Who screens me, and what does screening include?
  • Who gives the medicine and monitors me?
  • Which route would you consider for me, and why?
  • How will this fit with the care I already have?
  • What does it cost, and what does insurance cover?
  • Is preparation and integration support included?

Colorado's separate natural medicine program covers psilocybin, not ketamine. Ketamine always runs through licensed medical providers.

Where Off Weekend fits

The human part around the medical part.

What I do (trained facilitator, not a therapist)

  • Free 15-minute intro call
  • Preparation
  • Session-day support, within what the medical partnership allows
  • Integration afterward

What licensed medical partners do

  • All medical screening
  • Deciding whether ketamine is appropriate
  • All prescribing, dosing, administration, and monitoring

Compare the two session formats What a session day looks like

FAQ

Quick answers.

Is ketamine FDA-approved for depression?

Ketamine is FDA-approved as an anesthetic, so its use for depression and anxiety is off-label. Esketamine (Spravato), a nasal spray made from ketamine, is FDA-approved for treatment-resistant depression in adults.

Can ketamine help with anxiety?

It's sometimes used off-label for anxiety, and research suggests it may help some people. The FDA-approved psychiatric use (esketamine) is for depression. A licensed provider decides what's appropriate.

Do you decide whether ketamine is right for me?

No. I'm a trained facilitator, not a therapist or medical provider. A licensed provider screens you and decides whether ketamine is appropriate and, if so, the path, route, and dose.

Is at-home ketamine safe?

The FDA has cautioned about risks of compounded ketamine products, including oral forms, used for psychiatric conditions without monitoring. Talk with a licensed medical provider.

Sources

  1. Cleveland Clinic. “Ketamine Therapy: What It Is, How It Works & Side Effects.” Medically reviewed January 16, 2026.
  2. Rosenbaum SB, Gupta V, Patel P, et al. “Ketamine.” StatPearls, NCBI Bookshelf, U.S. National Library of Medicine.
  3. U.S. Food and Drug Administration, Drugs@FDA. SPRAVATO (esketamine) nasal spray: Prescribing Information (2025 label), including the SPRAVATO REMS requirements.
  4. U.S. Food and Drug Administration. “FDA warns patients and health care providers about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders.” October 10, 2023. Listed under FDA Compounding Risk Alerts.

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