Routes of Ketamine Administration

Surprisingly, it’s quite common for antidepressants to not provide the relief you need. In fact, 30% of depression patients do not respond to traditional antidepressants. In the medical field, this is called treatment-resistant depression. Luckily, ketamine and esketamine (branded as Spravato) affect the brain differently, with an impressive 75% success rate in patients who have tried four or more traditional antidepressants. We can compare this to the 10% success rate these patients are expected to have if they were to try another antidepressant medication.

Ketamine is fast-acting and may help patients feel better within hours of their first treatment.

When considering whether ketamine is right for you, it’s important to consider the three most common routes of ketamine administration, including intranasal, intravenous infusions, or intramuscular injections. At Manlove Brain and Body Health in Rapid City, we offer each of these routes of ketamine administration, which allows you and your provider the flexibility to adjust your treatment as needed.

Ketamine IV Infusion

When ketamine is given intravenously, patients will absorb roughly 99% of the medication. Since the medication is directly inserted into the bloodstream, patients are more likely to experience a sudden lift of their depression after a single dose.

During an IV infusion, our providers administer ketamine at a steady rate over roughly 40 minutes. IV infusions offer the greatest flexibility. Your provider will initially set your dosage and rate of administration based on your weight and, during the treatment session, adjust your treatment based on your response. This can greatly reduce your side effects.

Ketamine patients typically begin with six infusions over 2 to 3 weeks. After the first two weeks, the remaining doses may be spaced out a few weeks apart. However, the exact number of ketamine infusions needed depends on the individual.

Many patients require maintenance treatments at a reduced frequency. Typically, maintenance treatments are given every 4-6 weeks to start and taper off over time.

This route of infusion has been studied the most in the medical community so far. And, ketamine IVs are the most common choice among our patients.

Ketamine Shot

Ketamine may be injected into the arm. Treatments are quick but may require multiple injections in a single treatment session. When treatments are given intramuscularly, patients absorb up to 93% of the medication.

Compared to an IV infusion, our providers will have less control over the dosage during a given treatment session. However, your provider can adjust the dosage in subsequent treatment sessions based on your response.

Intramuscular injections follow a similar cadence to IV infusions. You can expect to receive six injections over the first 2-3 weeks, followed by one injection every few weeks as needed.

Ketamine Nasal Spray

Both ketamine and esketamine (Spravato) can be administered intranasally — in two strengths. When administered intranasally, patients absorb roughly 20-30% of the medication. This route requires more frequent treatments to have the same effect as intramuscular or intravenous infusions.

Typically, you will receive two treatments per week for the first four weeks, followed by one treatment a week for an additional five weeks.

Work with a Psychiatrist

Many clinics now specialize in ketamine. Specializing in a particular drug, versus a medical discipline (such as mental health or cardiology) is a relatively new and concerning development. For example, many of our patients have other psychiatric problems that also need to be treated while they receive ketamine. As a psychiatry clinic, our providers will be able to advise you on whether ketamine could worsen any other mental health conditions you may have.

Call today to schedule an introductory appointment. Our mental healthcare professionals will be happy to sit down with you to discuss if ketamine is right for you.