I Want Relief Fast: Is Ketamine Treatment the Right First Step for Me?

When life has narrowed and every day feels the same, it’s natural to want relief quickly and sustainably. Many patients ask whether ketamine therapy should be the first move rather than trying yet another medication.

What “fast relief” through ketamine therapy can realistically mean

“Fast” is relative. Some people notice a shift in mood, energy, or reactivity within hours to days of early ketamine treatment, especially during the first few doses. For others, change shows up later across the first month. It helps to name two terms up front:

• Response means symptoms improve in a clinically meaningful way. That can look like fewer bad days, steadier sleep, or an easier time getting started.
• Remission means symptoms are minimal or absent for a period of time. This is less common and usually requires more ketamine dosing. 

As with most mental health treatment options, Lumin Health advises all patients to expect variability in ketamine treatment. The signal we look for is the pattern of functioning across weeks, not a single dramatic day, though the latter can be a positive leading indicator and something that patients report commonly. 

Ketamine options when pace matters

Esketamine (Spravato)

• What it is: An FDA‑approved intranasal form of esketamine for treatment‑resistant depression.
• Where it happens: Only in a certified Spravato center with vital sign checks and observation after dosing. We refer to this as Spravato treatment.
• Cadence: Starting twice weekly for four weeks as per the FDA-approved label, then weekly for four weeks, then weekly or every other week thereafter, until such time as a patient and the care team think that spacing treatments out further makes sense, or even only coming in as needed.
• Driving: You will need a ride home and should not operate heavy machinery until the next day.
  
  

Off‑label ketamine

• What it is: Intramuscular ketamine dosing with on-site support. 
• Cadence: Many programs start with two sessions per week, then space sessions based on response. Due to the off-label nature of this form of ketamine, the cadence has more flexibility. 
• Coverage: More variable than Spravato treatment, with most patients paying out of pocket.

A quick fit check: is ketamine treatment the right first step for me?

Green flags for starting with ketamine therapy

• You’ve tried several antidepressants with limited relief and want a different mechanism.
• Pace of change matters to you right now, and you can arrange transportation on dose days.
• You feel open to a monitored experience that may include short‑term perceptual shifts.
• You have at least one supportive person who can help with rides, meals, or check‑ins.

Times another path may come first

• Symptoms are immediately dangerous or include psychosis or catatonia. In these cases, ECT or hospital‑level care may be prioritized for safety.
• You prefer to stay fully alert during all treatment experiences. Consider TMS or a structured medication plan.
• Transportation,childcare, or other obligations make clinic observation unrealistic this month. Stabilize logistics, then revisit.

If you start elsewhere, you can still explore ketamine for depression later, contingent on your healthcare providers agreeing that it is a reasonable next step in your treatment plan. 

What the first 4 days of ketamine/esketamine treatment can look like 

Ketamine dosing day (0–6 hours)

• Check in at the clinic. For Spravato treatment, staff guide intranasal dosing and monitor you. Off‑label IV or IM dosing includes similar monitoring.
• You may notice time feeling slower or thoughts feeling farther away during the treatment experience. Some people feel relaxed, others more alert. Staff are there to help
• Plan a ride home. Keep the evening quiet, lights low, and meals simple.

Evening and overnight

• Rest, check in with yourself. Plan events or work obligations in accordance with how you come back to yourself after a treatment.

Next day (24 hours)

• Some people feel lighter or more willing to try a small step; others (rarely) feel tired. 
• Practice some activating behaviors. Explore interests. Connect with others. Get a good walk in.

Day two and three (48–72 hours)

• This period may offer a neuroplasticity window when practicing one or two skills feels a bit more accessible and, when practiced, can feel more automatic (your brain is in an active learning state). If you work with a therapist or other behavioral support, a brief session in this window can help you apply a small behavior change without pressure. You can (and should!) also set your own goals.

Safety and support during ketamine therapy 

• Monitoring: Blood pressure and other vitals are checked during dosing. Tell staff about any nausea or discomfort so they can help.
• Driving: Do not drive after ketamine dosing. Arrange a pickup and keep the evening calm.
• Home prep: Lumin Health recommends setting out water, a light meal, and comfortable clothing. We also encourage asking a support person to check in by text or call.
• Communication: Decide in advance what you want to share with family or friends and prepare them accordingly. It’s completely up to you if you would like to talk about your experience with family and friends afterwards. If you do, we have helpful guides on how. 

Decision checkpoints and a workable Plan B

Lumin Health recommends reassessing progress throughout treatment 

• Symptoms: mood, anxiety, sleep, and specific target symptoms you care about.
• Function: steadier sleep and wake times, movement, connection with others, and engagement in one or two valued activities.

If a positive response is emerging, continue and modify the treatment course per your clinician’s guidance. If the response is partial, talk about it with your providers. There are ways of both budging things along and also ways of making the most of a response that is helpful even if not categorical.

Logistics and access to Spravato and ketamine therapy 

• Coverage: Spravato treatment is often covered for treatment‑resistant depression when criteria are met. Prior authorization is a common requirement, and Lumin Health processes this in-house so you do not have to worry. Off‑label ketamine coverage varies by plan and clinic.
• Time: Expect 2 hours of being onsite at a medical practice to receive the treatment (ketamine and esketamine) with some time to recover. Some people can work or study on treatment days. Others need a bit more time to process the experience and feel like themselves, again. It all depends on how a person responds.
• Transportation: A ride is required after ketamine/esketamine treatment, as reaction time can be slowed after treatment. Consider setting up a repeating calendar event with your driver or rideshare plan.
• Work or school letters: Lumin Health can provide documentation to explain visit length and temporary driving limits.
  
  

FAQs

How soon could I notice a change with Spravato?
Some people notice shifts within hours to days of early doses. Others feel changes later in the first month. Both patterns are common.

Can I work on dosing days?
Plan for a quiet evening after Spravato treatment and avoid driving. Working and studying after treatment is possible for most – a person should see how their individual body responds to treatment. 

What if nothing shifts by week 3 or 4?
Tell your Lumin Health team. They may adjust dose, timing, or cadence. We also have continual conversations with patients throughout their entire journey..

Can I keep my current meds during ketamine treatment?
Yes. Many patients continue antidepressants and sometimes augmentation medicines while receiving ketamine therapy. Your primary healthcare professional and your Lumin Health team will coordinate safety and dosing.

Do I need psychotherapy for this to work?
No, psychotherapy is optional. That said, many people find psychotherapy quite helpful – both to process the treatment experiences and to process/enhance recovery. 

Is off‑label ketamine the same as Spravato?
They are related, but not the same. Esketamine (Spravato) is FDA‑approved and delivered inside a certified protocol with observation. Off‑label ketamine is delivered through intramuscular ketamine dosing with variable coverage.

A steady way to try a faster path

If speed matters, ketamine for depression can be a reasonable first step. It’s important to start with a plan you can keep, and you can develop that with collaboration from your existing care team and with Lumin Health. For example, schedule Spravato treatment on predictable afternoons, line up rides, protect dose evenings for rest and recovery, and take time to think about the behaviors or therapy you want to bring into treatment to make the most out of the treatments. 

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