How Quickly Does Ketamine Therapy Start Working — and How Long Does Relief Last?
When considering ketamine therapy or esketamine (Spravato) treatment, some of the most important questions are: When will I feel relief, and how long might it last? This isn’t just a clinical or pharmacological question — it’s deeply personal. It’s based on hope, a desire for relief, a desire for a different kind of treatment with a different kind of result. For those living with a history of treatment-refractory depression, anxiety, or trauma, the timeline of change matters deeply. Dr. Ben Yudkoff often describes three intertwined realities: the different timelines of response, the varying duration of relief, and why ketamine and esketamine may not work for everyone. As we think about this together, we’ll refer to ketamine and esketamine collectively as ketamine as the story of the two of them is so similar.
The Four Response Stories: How Soon Relief Can Begin
Immediate Responders to Ketamine Therapy
A small group of patients describe profound changes after their very first session. Some notice shifts the same day — colors feel brighter, thoughts feel less heavy, and social engagement feels possible again. While dramatic, this kind of immediate response is relatively uncommon, perhaps 15–20% of patients. It’s a meaningful number of people and for those who have such a dramatic shift, it can feel miraculous and strange all at the same time.
Early Responders to Ketamine Treatment
For many, meaningful relief begins after one to two weeks of treatment. Clinical studies of esketamine (Spravato) suggest the most significant improvement often occurs within the first two to three weeks. Patients in this category frequently describe the gradual return of energy, hope, or emotional range.
Late Responders to Ketamine
Some individuals only feel benefit after several weeks or after adjustments in dosing. For them, improvement may feel slower — yet no less important. This trajectory reflects the reality that every brain responds differently.
Non-Responders to Ketamine
Not everyone experiences benefit. Some may find ketamine therapy or Spravato treatment does not meaningfully shift symptoms. Understanding this possibility upfront helps patients make informed decisions without misplaced expectations. We are here to help.
How Long Do Ketamine’s Benefits Last?
The relief ketamine therapy brings is often described in windows — sometimes brief, sometimes extended. What matters most is learning how these windows open and how to support them. It is difficult to predict how long a treatment will last for the individual.
Acute Shifts vs. Sustained Changes
Some patients feel better for only a few days after a ketamine or esketamine (Spravato) dose, while others maintain relief for weeks. The difference is shaped by both biology and context.
Supporting Ketamine’s Durability
Clinicians often recommend a structured series of treatments to build stability, then tapering to maintenance. Behavioral support, psychotherapy, and lifestyle practices during the neuroplasticity “window” may extend benefit.
Why Ketamine Therapy Can Work for Some but Not for Others
Just as depression is not one single illness, ketamine is not one single solution. Dr. Yudkoff frames non-response through four overlapping lenses:
Ketamine’s Chemistry
Each person’s neurobiology differs. Variations in the biological targets for ketamine, genetics, psychology, social stressors, or the neural networks that produce the experience of depression may affect how ketamine works.
The Biology impacted by Ketamine
Chronic stress, trauma, or medical conditions may change the brain’s ability to form and sustain synaptic connections. For some, ketamine’s boost in neuroplasticity is limited by the biology it works upon.
Psychology
Ketamine can create openness, but expectations, the nature of current stressors, and how we process emotional material, and how improvement generates its own stress shape outcomes.
Life Circumstances
External context — supportive relationships, stressors, or stability of daily life — plays a role in how much relief translates into lasting change.
FAQs About How Long Ketamine Takes to Work
How many ketamine sessions are usually needed before knowing if it works?
Many clinicians assess after six to eight sessions. Some patients notice change earlier while others require more time.
Is Spravato faster or slower than ketamine?
Both act on the glutamate system. Spravato is FDA-approved and insurance-covered, while generic ketamine is used off-label. The response timelines are generally comparable, but with some slight differences. For more information, visit our comparison page at https://www.lumin.health/ketamine-and-esketamine
Can ketamine therapy provide permanent relief?
For most, ketamine is not a permanent cure. It may, however, create windows of neuroplasticity where lasting changes can be made with or without additional support.
What if I don’t respond at all?
At Lumin Health, we firmly believe that non-response does not mean failure. It may reflect individual biology or context. Other treatment options, including different medications or therapies, remain possible.
Returning to What You Experience During Ketamine
Ketamine therapy and Spravato treatment offer possibilities — sometimes immediate, sometimes gradual, and sometimes elusive. Relief may last days or weeks, or it may not arrive at all. None of these stories are wrong. They are simply different paths brains can take. At Lumin Health, the goal is not to promise a miracle, but to accompany each patient with honesty, care, and curiosity. Whether ketamine opens a door briefly or helps build a new foundation, what matters most is that the path forward remains yours to choose.
