Primary Care Providers (PCPs) & Ketamine/Spravato: A Practical Guide
Primary-care clinicians often sit at the very center of a patient’s mental health story. The PCP
“runs point” and often is the most accessible provider a patient may have. You see the slow changes— the loss of appetite, the exhaustion that no bloodwork explains, the social withdrawal, the small admission of “I’m still not better.”
For many patients, you are typically the first to sense when standard antidepressant therapy has reached its limit. And in those moments, the conversation about ketamine therapy or esketamine (Spravato) may begin.
This guide offers a concise, clinically grounded framework for screening, referral, and shared follow-up — so that when you raise the option of ketamine treatment, it feels both safe and familiar to you and to your patient.
From First Conversation to Shared Monitoring
Red flags and contraindications to screen
The best candidates for ketamine therapy or esketamine (Spravato) treatment are adults with depression and — in the case of ketamine — anxiety or PTSD that have not responded to standard treatment. But safety, eligibility and readiness always come first.
Lumin Health conducts a comprehensive screening to determine safety & eligibility, but here are some of the main components you can keep in mind:
- Cardiovascular health: Be sure that hypertension is controlled and that cardiac function is sufficient to be able to tolerate a 10-20 bpm increase.
- Neurovascular health: a recent history of stroke, especially hemorrhagic stroke, is worrisome. Attention to the stability of epilepsy is also important.
- Psychiatric stability: Exclude active psychosis, untreated mania, or acute substance intoxication.
- Pregnancy and lactation: Ketamine and esketamine cross the placenta and are not recommended during pregnancy.
- Substance use history: Mild or remote use can be manageable; active misuse requires stabilization first.
- Social supports: Confirm that the patient has reliable transportation, a contact person, and an environment conducive to rest after sessions.
A primary-care screen that clarifies these factors allows specialty clinics to move quickly into precise risk assessment and treatment planning for ketamine therapy and/or esketamine (Spravato). If there are questions after an expert evaluation by a psychiatrist, nurse practitioner, or physician assistant, we’ll be in touch.
What to tell patients about ketamine mechanisms and safety
For many, “ketamine” still carries stigma or misunderstanding. A clear, calm explanation helps patients approach the idea with curiosity instead of fear.
Simple language you can use:
“Ketamine works differently from most antidepressants. Instead of acting on serotonin, norepinephrine, or dopamine, it targets the brain’s glutamate system — helping nerve cells reconnect and communicate more effectively. That change can open new pathways in the brain and, for some people, relief arrives within days instead of months.”
Remind patients that ketamine treatment at Lumin Health is not an at-home or unsupervised treatment. Sessions take place in medical settings under continuous observation:
- Esketamine (Spravato) is FDA-approved, REMS-certified, insurance covered, and always administered on-site via nasal spray.
- Off-label ketamine therapy (intramuscular injections at Lumin Health) follows a similar safety structure with continuous vital-sign monitoring and post-dose observation.
Most patients experience mild dissociation or dizziness for about an hour. These sensations are expected, temporary, and supervised.
A phrase that often helps:
“You may feel like you’re watching your thoughts from a distance — that’s a normal and monitored part of how the medicine works.”
How visit summaries and communication flow with Lumin Health’s ketamine treatment program
Effective ketamine for depression requires coordinated care. Primary-care clinicians remain essential for longitudinal monitoring of blood pressure, weight, metabolic status, and medication management.
In a well-structured referral, you can expect:
- Evaluation summary: Confirmation of eligibility, baseline measures, and dosing plan.
- Interim updates: Concise notes at regular intervals, detailing response, tolerability, and any observed side effects.
- Maintenance or discharge plan: Clear recommendations for follow-up care, including connecting the patient to a psychiatrist or psychotherapist.
If questions arise — blood-pressure spikes, overlapping prescriptions, or functional changes — you will have direct access to the Lumin Health treating team. Shared documentation is not just good communication, it’s a crucial safety layer.
A Partnership of Trust and Tempo for Ketamine Therapy at Lumin Health
For many patients, ketamine therapy represents hope arriving faster and more effectively than typical treatments. Relief that might take months with antidepressants if it comes at all can sometimes come within days or weeks. That speed matters for the sense of self-efficacy and participation in life that mental illness can erode.
All that said, rapid relief doesn’t replace ongoing care. Primary-care clinicians remain the steady base — the provider who keeps an eye on a patient’s progress and response.
Ketamine treatment works best when that collaboration is seamless:
- You identify readiness and screen for safety in your patients.
- The Lumin Health ketamine treatment team handles dosing, monitoring, and structured feedback.
- Together, we track outcomes that actually matter — function, energy, hope, and the return to meaningful daily activity.
When done well, the process feels less like a referral and more like shared care — two clinical practices walking alongside one patient, toward a future that feels reachable again.
PCPs & Ketamine/Spravato: A Practical Guide
Primary-care teams are often the first to notice when standard antidepressants are falling short. This guide provides practical tools for screening, counseling, and collaboration around ketamine therapy and Spravato treatment. It covers contraindications, patient-friendly explanations of mechanism and safety, expected communication flow, and how we coordinate when medical concerns arise.
