IV Ketamine Therapy

IV ketamine therapy works differently than traditional antidepressants. Ketamine primarily acts on the NMDA receptor system, increasing glutamate activity and promoting neuroplasticity, the brain's ability to form new neural connections. Unlike SSRIs, which may take weeks to work, IV ketamine often produces noticeable improvements in depression, anxiety, and PTSD symptoms within hours to days.

Emerging research suggests ketamine's antidepressant effects involve multiple pathways beyond the NMDA receptor, including changes in inflammation, synaptic connectivity, and brain network function. At Soft Reboot Wellness, IV ketamine therapy is administered in a physician-supervised, monitored clinical setting.

Most patients begin with a six-session IV ketamine therapy series, typically scheduled once per week over six weeks. Research suggests that a series of treatments produces more durable improvements in depression, anxiety, PTSD, and chronic pain than a single infusion alone.

At Soft Reboot Wellness, we intentionally space treatments one week apart to allow time for neuroplasticity, integration, and meaningful change between sessions. While ketamine can help create a window of increased flexibility in the brain, lasting healing occurs through the reflection, therapy, lifestyle changes, and new patterns developed outside the clinic.

After the initial series, some patients benefit from maintenance ketamine infusions every 4 to 8 weeks, while others maintain benefits without additional treatment. Every treatment plan is individualized based on symptoms, goals, and response to therapy.

IV ketamine therapy and Spravato (esketamine) are both ketamine-based treatments, but they differ significantly in formulation, delivery method, bioavailability, and dosing flexibility.

IV ketamine delivers the complete ketamine molecule directly into the bloodstream, providing nearly 100% bioavailability and allowing precise, physician-controlled dosing that can be individualized for each patient. Because the medication is administered intravenously, absorption is predictable and treatment can be adjusted in real time based on response and comfort.

Spravato is a nasal spray containing only esketamine (the S-enantiomer of ketamine). Intranasal absorption is variable, with bioavailability of approximately 40% to 50%, meaning a significant portion of the medication does not reach the bloodstream. Spravato is self-administered under supervision and is available only in fixed-dose increments, limiting personalization.

At Soft Reboot Wellness, we primarily offer IV ketamine therapy because of its superior bioavailability, precise dosing, predictable delivery, and extensive research supporting its use for depression, PTSD, anxiety, chronic pain, and other nervous system-related conditions.

Most insurance plans do not cover IV ketamine therapy for depression, PTSD, anxiety, or other psychiatric conditions because ketamine remains an off-label treatment, despite a growing body of research supporting its safety and effectiveness.

Soft Reboot Wellness is an out-of-network practice and does not bill insurance directly. However, we can provide a detailed superbill that patients may submit to their insurance company for potential out-of-network reimbursement. Reimbursement varies by plan and is not guaranteed.

This is an important question. Ketamine is not considered physiologically addictive in the same way as opioids, nicotine, alcohol, or benzodiazepines. Most patients do not develop physical dependence on ketamine when it is used appropriately in a medical setting.

That said, ketamine can produce experiences of dissociation, relief, escape, or temporary freedom from emotional pain. Like many things that help us avoid discomfort—including social media, shopping, pornography, gambling, or excessive screen time—there is a potential for some individuals to become psychologically attached to the experience rather than engaging in the deeper healing work required for lasting change.

At Soft Reboot Wellness, we believe ketamine is a tool, not a cure. The medication itself is only a small part of the healing process. Lasting improvement typically comes from the work that happens between sessions through psychotherapy, integration, self-reflection, lifestyle changes, and nervous system regulation practices.

When ketamine is administered in a physician-supervised setting with careful screening, preparation, and integration support, the risk of problematic use is significantly reduced. In fact, ketamine-assisted therapy is being actively studied as a treatment for certain substance use disorders and may help some individuals break entrenched patterns of addiction.

Our goal is never to help patients escape their lives. Our goal is to help them engage with their lives more fully, with greater flexibility, resilience, and self-awareness.

Ketamine is a well-established medication that has been used in hospitals and emergency settings for decades and is listed by the World Health Organization as an essential anesthetic medicine. It was even used during the 2018 Thai soccer team cave rescue because of its unique safety profile in medically challenging conditions.

For mental health treatment, IV ketamine is given at much lower doses than those used for anesthesia. At Soft Reboot Wellness, every IV ketamine infusion is physician-supervised in a monitored clinical setting with attention to blood pressure, heart rate, oxygen levels, comfort, and emotional support.

Common side effects are usually short-lived and may include dissociation, nausea, dizziness, blurred vision, fatigue, or temporary increases in blood pressure. IV ketamine therapy is not appropriate for everyone, which is why each patient completes a detailed intake and medical consultation before treatment.

IV ketamine therapy may be appropriate for individuals struggling with depression, treatment-resistant depression, PTSD, anxiety, OCD, chronic pain, Long COVID, or nervous system dysregulation who have not found sufficient relief with traditional treatments.

The best candidates are medically stable, motivated to engage in the healing process, and either actively participating in psychotherapy or willing to begin regular therapy. At Soft Reboot Wellness, we view ketamine as a powerful tool, not a cure. While ketamine can create a window of increased neuroplasticity and openness to change, lasting healing typically comes from the work that happens outside the clinic through therapy, integration, self-reflection, and lifestyle changes.

IV ketamine therapy may not be appropriate for individuals with active psychosis, uncontrolled cardiovascular disease, certain untreated medical conditions, or active substance misuse. Every patient undergoes a comprehensive medical and psychiatric evaluation with one of our physicians to determine whether ketamine therapy is safe and appropriate for their individual circumstances.