3 Pros And 3 Cons Of Ketamine Therapy

• By Karla Tafra
• May 19, 2021July 1, 2026
• Ketamine Articles ketamine therapy ketamine treatment
• With 1 comment

Last reviewed and updated: July 1, 2026.

Key Takeaways

Ketamine therapy has become available in many clinics all over the world. Indeed, ketamine therapy is an increasingly popular option for treating many mental health issues. But every psychedelic-assisted therapy has its pros and cons.

Ketamine is a psychedelic substance well-known as an anaesthetic and a party drug. It’s also recently been linked to helping alleviate symptoms of many mental health issues. These include depression, PTSD, bipolarity, anxiety, and even mood disorders.

With high rates of success, many scientists and psychedelic researchers are joining the cause. Many hope that ketamine therapy will soon gain full approval. Only in this way will it become available to those who desperately need it.

Looking for ketamine therapy? Click here to find top rated ketamine clinics near you

The Pros of Ketamine Therapy

Ketamine Therapy is Quick and Easy

Ketamine can be administered in two different ways:

• As an FDA-approved nasal spray (Spravato) for those struggling with treatment-resistant depression which “must be administered in a certified medical office where the health care provider can monitor the patient.”
• As an IV treatment using racemic ketamine, still not approved by the FDA.

Unlike most psychedelics, ketamine doesn’t take days or special ceremonies to be administered. Ketamine nasal spray is self-administered under the supervision of a health care provider. This takes place in a certified doctor’s clinic. The therapy includes two hours of extra supervision afterward. This ensures the patient is safe to drive themselves home.

The IV therapy usually takes six infusions over the course of two weeks. Each Ketamine IV session lasts 45 minutes to an hour. The only downside is finding a driver to take the patient to and from the clinic, as he or she will not be able to drive. But other than that, the session itself is pretty quick and simple.

Ketamine Therapy Presents Little to No Side Effects

Possible side effects are a fear for many considering psychedelic-assisted therapy. This is especially true since they’re mostly classified as hallucinogens. Psilocybin, MDMA, LSD, ayahuasca and others can potentially cause psychedelic side effects. These include visual hallucinations, vomiting and nausea, diarrhea, confusion, anxiety, euphoria, heightened senses, insomnia, and others.

Ketamine, on the other hand, has shown very mild, if any, side effects. The most common side effect of ketamine is feeling a little bit “out of place” after the treatment. Since ketamine is an anaesthetic, expect some dissociation and drowsiness. That said, every person is different, and more serious symptoms can still occur.

Ketamine Therapy Provides Successful, Fast-Acting Symptom Relief

Whether nasal spray or infusion, ketamine therapy works fast. ‘Fast’ in this case means within a few hours of treatment. People report a massive ease in depressive symptoms very soon. This is something scientists have yet to understand. However, links to a rapid increase in glutamate have been discovered.

Ketamine stimulates the increase in glutamate. Glutamate is an important amino acid and the main neurotransmitter encouraging growth of synapses in the brain. It helps strengthen and restore important neural connections and pathways. It does so in the regions of the brain that are most impacted and impaired by depression. Once these new connections are created, something pretty miraculous happens. They induce beneficial changes in brain circuit function and decrease depression symptoms.

Additionally, here’s what Mindbloom’s Medical Director, Dr. Leonardo Vando — a board certified psychiatrist and addiction psychiatrist with over 15 years — adds about ketamine’s fast-acting relief.

Many clients feel results immediately after their first session, but it varies from person to person. In the largest-ever study of ketamine therapy published in the October edition of the Journal of Affective Disorders, over 30% of clients achieved remission of their depression or anxiety after just four sessions of at-home ketamine therapy, and 89% of clients reported an improvement in their depression or anxiety. You can read more about the transformative results that many Mindbloom clients have on our website.

Looking for ketamine therapy? Click here to find top rated ketamine clinics near you

Ketamine therapy is still being studied fully. But, current research shows high success rates and significant symptom relief after only a few infusions. This may be key for ketamine to receive acknowledgment and FDA approval (beyond Spravato, the nasal ketamine treatment that was approved by the FDA) in the near future.

RELATED: How Much Is Ketamine Therapy, And How Can You Pay?

The Cons of Ketamine Therapy

Ketamine Has Addictive Potential

Unlike other psychedelics used to treat drug addiction, ketamine does have addictive potential. This potential, granted, is only slightly more so than cannabis. Ketamine’s addictive potential sways more towards the psychological side. However, it is still different from an opioid addiction.

As a dissociative, ketamine can trigger escapism. Escapism happens when a person separates from their sense of the world and self. This usually takes place as a way to avoid painful feelings instead of confronting them. Escapism is an addictive feeling as it gives a sense of “freedom” from personal problems. Indeed, stopping ketamine can create psychological withdrawal symptoms. These can include strong cravings, anxiety, and loss of pleasure. The addiction itself can even lead to serious organ damage.

However, when ketamine is used carefully, the likelihood of addiction is substantially low. When ketamine is taken out of a monitored, clinical context, safety controls are removed. Dosage and frequency are less regulated, and this leads to potential addiction.

Ketamine Clinic Spotlight: Redemption Psychiatry – Chandler, Arizona

Ketamine Clinics Aren’t Yet Regulated

So where is ketamine legal? Psychedelic-assisted therapies are still very controversial. While they’re legal, ketamine therapy clinics aren’t exactly regulated. This could result in untrained staff who aren’t certified to administer ketamine dosages.

However, there are some rough industry guidelines. Take the consensus statement published in JAMA Psychiatry for example. There are teachings from organizations like the KRIYA Institute that can also provide guidance. The American Society of Ketamine Physicians (ASKP) is another. However, these are purely suggestions for guidelines that ketamine clinics should, but not required, to follow.

Ketamine Therapy is Expensive

When it comes to crunching numbers, ketamine therapy will not go easy on your wallet. They typically cost up to $1,000 per infusion, and treatment usually includes six infusions. Since ketamine therapy does not have FDA approval, insurance companies do not cover costs.

This can be a big reason for someone to think twice before signing up for a consultation. Indeed, a consultation fee of around $350 typically exists. Until standard approval and regulations for ketamine therapy is intact, each clinic can charge any amount.

However, the pros still outweigh the cons when it comes to the potential of ketamine therapy. For those suffering from treatment resistant depression, ketamine therapy may be a solution. But it’s up to potential users to find a well-respected ketamine clinic and do the research.

Updated Assessment: How the Pros and Cons Have Shifted With Five Years of Real-World Data

The pros and cons calculus for ketamine therapy has shifted significantly since this article was written, and not symmetrically. The pros have gotten stronger: the evidence base is deeper, the speed advantage is more clinically validated than ever, and a new FDA approval has opened an insurance-covered pathway that did not meaningfully exist five years ago. The cons have also evolved: cost remains the top barrier for IV ketamine, but new access options have introduced new categories of risk that the original pros-and-cons framework did not anticipate.

On the pro side, speed remains ketamine’s most clinically distinctive feature. Conventional antidepressants (SSRIs, SNRIs, TCAs) require 4–6 weeks to produce a therapeutic response, during which time a severely depressed or suicidal patient is waiting. Ketamine works within hours to days. This is now the standard clinical argument for ketamine in acute suicidality and treatment-resistant cases, and it has been formalized into FDA labeling: Spravato (esketamine) received FDA approval specifically for major depressive disorder with acute suicidal ideation or behavior, in addition to treatment-resistant depression. The evidence base backing this claim has grown substantially — Spravato is generating $400M+ per quarter in revenue, representing hundreds of thousands of patient-treatment episodes of real-world evidence beyond the original clinical trials. This is no longer a fringe intervention; it is mainstream psychiatry for the right patient population.

The cost con remains the most significant barrier, but it now has a partial workaround via the Spravato pathway. IV ketamine is still always out-of-pocket — $2,400–$4,800 for a standard six-session induction protocol, with maintenance infusions every 4–8 weeks for many patients thereafter. That maintenance reality is the second major con that the original article underweighted: ketamine is not a cure, and the majority of patients who respond well will require ongoing treatment. The cost of indefinite IV ketamine is not sustainable for most people. Spravato with insurance changes this calculus for patients who meet the TRD or suicidal ideation criteria, but requires prior authorization and a certified provider — still not frictionless.

The telehealth oral ketamine boom has introduced a new dimension to the cons column. Services that prescribe and mail oral ketamine (lozenges, troches) with minimal oversight have expanded access significantly — but they have also expanded access to ketamine without adequate clinical support. The main risks are not primarily pharmacological: oral ketamine at prescribed doses is generally safe. The risks are contextual: no integration support, no mental health monitoring between sessions, no safeguards against misuse escalation, and no clinical safety net if a patient has a difficult experience. For patients who can afford IV ketamine with proper clinical oversight, telehealth oral is a step down in both evidence quality and safety infrastructure. For patients who cannot access or afford IV, it may still be preferable to no treatment — but with eyes open about what is and is not present. Dissociation side effects, the remaining original con, remain real: not everyone tolerates the perceptual effects of ketamine well, and a subset of patients discontinue because the experience itself is too disorienting regardless of therapeutic benefit.

Frequently Asked Questions

How long does ketamine therapy last for depression?

Ketamine’s antidepressant effects typically last days to weeks after a single infusion and several weeks to months after a full induction protocol (usually six infusions over two to three weeks). The pattern varies significantly by individual: some patients sustain benefit for months after a single course, while others experience a return of symptoms within two to four weeks and require ongoing maintenance infusions. Most patients who respond well to ketamine are not cured — they are managed. This is similar to other psychiatric treatments, but the framing matters because the cost of indefinite IV maintenance ($400–$800 per infusion every four to eight weeks) is substantial and needs to be planned for. Some patients find that adding psychotherapy or integration sessions between ketamine infusions extends the duration of benefit, possibly by making use of the elevated neuroplasticity window that follows each session.

Who is a good candidate for ketamine therapy?

The strongest candidates are people with treatment-resistant depression (TRD), defined as failure of at least two antidepressants at adequate dose and duration; people with MDD and active suicidal ideation where a fast-acting intervention is clinically urgent; people with PTSD, particularly when combined with psychotherapy; and people with chronic pain conditions that have a depression comorbidity, such as CRPS or fibromyalgia. Ketamine is most clearly indicated when the conventional timeline for antidepressant response (four to six weeks) is clinically unacceptable due to severity, or when multiple antidepressants have failed. It is not indicated as a first-line treatment for mild-to-moderate depression with no prior treatment history, where standard antidepressants and psychotherapy have not been adequately tried.

What are the main risks of ketamine therapy?

The main clinical risks are: (1) Dissociation and perceptual disturbance during infusions — this is intended and transient but can be distressing for some patients, particularly on first exposure; (2) Blood pressure elevation — ketamine raises BP acutely during infusion and is contraindicated in uncontrolled hypertension; (3) Potential for misuse or dependence — ketamine has abuse potential (Ketamine Use Disorder is a recognized diagnosis); this risk is higher in unstructured telehealth settings with less monitoring; (4) Nausea during or after infusions — manageable with antiemetics like ondansetron but worth discussing with your clinic; (5) Limited evidence for very long-term use — we do not have extensive data on patients receiving ketamine maintenance for five or more years, though the existing data is not alarming. For in-clinic IV ketamine with proper medical oversight, the acute safety profile is well-established; the risks are primarily in inadequately supervised settings.

Is ketamine therapy a permanent cure for depression?

No. Ketamine therapy is not a cure for depression — it is a treatment that requires ongoing management for most patients who respond to it. The antidepressant effects of ketamine are time-limited and typically require maintenance infusions every four to eight weeks to sustain benefit. This is one of the most important things to understand before starting treatment: a significant response to ketamine should not be interpreted as the depression being gone, but as the depression being controlled by an intervention that will need to continue. Some patients are able to taper maintenance over time, particularly when ketamine is combined with effective psychotherapy; a subset do achieve sustained remission that allows them to stop ketamine eventually. But entering treatment with the expectation of a permanent single-course cure leads to disappointment and poor planning. The honest framing is: ketamine is a powerful tool for managing severe depression that has not responded to other treatments, not a one-time fix.

RELATED READING

• How Ketamine Affects the Brain
• How Ketamine Infusion Therapy Works
• Johnson & Johnson’s Spravato Surges Toward Blockbuster Status