As depression, anxiety, OCD, and PTSD continue to challenge conventional treatments, ketamine treatment has emerged not as a miracle cure, but as a potent and promising alternative. Still, its sudden popularity has left many patients and clinicians sorting through headlines, wondering what’s behind the resurgence of this decades-old anesthetic.
At its core, ketamine therapy is the medical and psychological use of ketamine — most commonly via infusion, intramuscular injection, or lozenge — in a structured, therapeutic context to treat a range of psychiatric conditions. At Lumin Health, our most common use is Spravato (esketamine) due to its safe-to-use administration and increased accessibility due to its robust insurance coverage. Ketamine, though, may present an important alternative to Spravato (esketamine) as its off-label, evidence-based application can be used to treat a range of disorders for which Spravato (esketamine) does not have an indication.
What is Off-Label Ketamine?
In these circumstances, ketamine is used “off label.” “Off-label” use of a medication refers to when a medication is prescribed for reasons other than those for which the medication was studied specifically for FDA-approval. As medications — ketamine included — have complex interactions with our biology, after a medication is approved by the FDA for the treatment of a specific illness, other potential benefits of the medication are then recognized. In these circumstances, the medication is prescribed “off label,” or outside the the treatment of a specific illness for which the FDA labeled the medication. Ketamine therapy is not simply a chemical intervention. When administered with intention, safety, and therapeutic support, it becomes a portal into neuroplastic change, psychological insight, and emotional renewal.
In this blog, we’ll explore what ketamine therapy is, what it is used for, and what makes it a meaningful clinical innovation in today’s mental health care ecosystem.
Ketamine Therapy Origins and Mechanism of Action
Originally synthesized in the 1960s, ketamine was approved for use as an anesthetic due to its unique ability to induce dissociation while preserving cardiac and respiratory function. Its early use in surgical and emergency settings made it a staple in trauma care, battlefield medicine, and pediatric procedures. But in the late 1990s and early 2000s, researchers began noticing something extraordinary: patients who received ketamine as an anesthetic often experienced rapid improvement in mood — sometimes within hours. There has been over 25 years of research into ketamine and its effectiveness in treating psychiatric conditions.
Unlike traditional antidepressants, like selective serotonin reuptake inhibitors) SSRIs, which modulate a chemical in the brain called “serotonin” — and sometimes other chemicals in the brain such as norepinephrine, dopamine, histamine, and acetylcholine — and often take weeks to show effects, ketamine acts the brain’s glutamate system, opioid receptor system, and brain cells called “astroglia.” Specific to its interaction with glutamate, where it is postulated it exerts its primary effect, it modulates a part of the brain called the NMDA receptor, triggering a cascade that increases brain-derived neurotrophic factor (BDNF) and enhances something called “synaptic connectivity” - this refers to process of how brain cells reach out and connect to other brain cells. These new connections form new channels by which information can be sent and can help the brain automatically rest in healthier states (i.e., states which are less inclined toward psychiatric symptoms).
This mechanism not only explains its rapid effects — it also opens a new chapter in the biological understanding of depression, trauma, and resilience.
What is Ketamine Therapy Used For?
So, what is ketamine therapy used for in clinical practice today? While the field is still evolving, the most common evidence-based indications include:
1. Treatment-Resistant Depression (TRD)
Patients with depression who have not responded to two or more antidepressant trials have a depression that is “treatment-resistant.” For this group, ketamine has been shown to reduce symptoms rapidly — sometimes within hours — and may also help in reducing suicidal ideation. The quick potential onset makes ketamine therapy particularly valuable to people where traditional medications fall short and waiting for weeks-to-months has been the norm.
At Lumin Health, this is primarily what we work with patients on due to the prevalence of treatment-resistant depression. It also is the primary indication for Spravato (esketamine) as the first and currently only monotherapy approved by the FDA for treatment-resistant depression.
2. Anxiety and PTSD
Emerging research suggests ketamine may help recalibrate the brain’s threat-response system, which becomes overactive in PTSD and generalized anxiety disorder. In a supported setting, ketamine treatment may allow patients to revisit traumatic memories and material without becoming overwhelmed, which can facilitate deep emotional processing. Combined with psychological support such as talk therapy and/or psychotherapy, ketamine treatment can lead to lasting symptom reduction. Anxiety disorders, especially Generalized Anxiety Disorder, has been studied in case reports and smaller-scale studies. The evidence suggests that, for some, off-label use of ketamine can help treat symptoms of pervasive worry and anxiety.
3. Bipolar Depression
While ketamine is not suitable during manic states, it has shown promise in alleviating depressive episodes in bipolar disorder. Careful screening and mood stabilization are essential for this use case. If considering use of ketamine to treat a depressive disorder occurring for someone who has bipolar disorder, communication with one’s treatment team is so important for careful monitoring of the first signs of hypomania or mania. Some recent studies have shown promise in the use of ketamine in treating treatment refractory depression (source and source)
Outside of Managing Symptoms, What Is Ketamine Therapy Good For?
This question — what is ketamine therapy good for — requires more than a list of diagnoses. Clinically, ketamine therapy is good for creating a space where emotional openness, neuroplasticity, and therapeutic insight can intersect. In many cases, patients describe their sessions as profound, not just because symptoms improve, but because they feel something shift — internally, meaningfully, often inexplicably.
1. Catalyzing Psychological Change
Many patients describe ketamine therapy as “unlocking” perspectives that have remained unreachable in talk therapy and traditional interventions such as antidepressant medications, alone. This may include unprocessed grief, repressed memories, or existential insight. The dissociative quality of ketamine treatments has been shown to temporarily quiet the default mode network — our brain’s narrative hub — allowing for new perspectives to emerge.
2. Supporting Integration
Ketamine sessions are typically bracketed by preparatory and integration sessions with a clinician like at Lumin Health or a person’s own therapist. These sessions process the experiences, themselves, and how to take the benefit experienced from the medication and move it into meaningful change - change in how we think and change in the healthy habits we adopt.
3. Restoring Hope
For patients who have tried medication after medication without relief, ketamine treatment offers something rare: hope. Not only because it can work quickly, but because it often shows patients that change is possible — that the mind is never as fixed as it once seemed.
How Ketamine Therapy Works in Practice
At Lumin Health, our ketamine therapy protocols combine medical safety with psychological depth. Patients begin with a comprehensive evaluation — covering mental health history, physical health, medication use, and personal goals. Based on this, a treatment plan is developed, which may include:
- Route of administration: At Lumin Health, we provide an intramuscular shot of ketamine, similar to the way a standard vaccine is provided.l
- Number of sessions: Typically 6-to-8 initial treatments, followed by reassessment to evaluate treatment course
- Intention setting and preparation: Supporting the mindset before entering the experience
- Processing the experience: thinking with you about goal setting and what the sessions mean to you.
Throughout, we monitor both outcomes and side effects. While ketamine is generally well-tolerated, it can cause nausea, dissociation, or elevated blood pressure, to name a few, in some individuals. Ongoing communication between patient and provider ensures that the treatment remains aligned, ethical, and effective.
So How Can You Start Ketamine Therapy at Lumin Health?
So — what is ketamine therapy? It is a treatment, a journey, and at times, a profound reorientation. It offers relief not through numbing, but through opening: to emotion, memory, possibility. When held with care, it becomes more than a pharmacologic event; it becomes a turning point.
As the field matures, we must remain both hopeful and humble — honoring the complexity of healing, the power of the medicine, and the courage it takes to walk into the unknown. If interested in initiating ketamine treatment or just learning more about it, please give us a call at 617-863-8810 and we can discuss your questions and explore next steps.
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