Answers to common questions about ketamine-assisted therapy
Ketamine is a medication that has been safely used in medicine for over 50 years. In sub-anesthetic doses, it has shown strong effectiveness for treatment-resistant depression, and growing evidence supports its use for anxiety, PTSD, and certain chronic pain conditions. Dr. Almeida’s approach combines medically supervised ketamine administration with intentional preparation and deep post-session integration, creating a structured process where insight becomes grounded, embodied, and sustainable.
When administered by a licensed physician in a controlled medical setting, ketamine therapy has an well-established safety profile when administered in appropriate medical settings. Ketamine is recognized by the World Health Organization as an essential medication. Every patient undergoes thorough medical screening before treatment. During sessions, you are continuously monitored by Dr. Almeida. All treatments are delivered in a structured and monitored setting under direct medical supervision. Emergency protocols are in place for every session.
Ketamine-assisted therapy is widely recognized for treatment-resistant depression and major depressive disorder, with growing evidence supporting its use for generalized anxiety, PTSD, and certain chronic pain conditions. It is also increasingly used to support burnout and the kinds of existential challenges that arise when familiar ways of coping no longer feel sufficient. During your initial consultation, Dr. Almeida will discuss your specific situation and determine whether ketamine therapy is appropriate.
Experiences vary widely. Some people notice imagery or insights, others experience emotional release, and some simply feel a sense of spaciousness or calm. Many describe a shift in perspective—less identification with anxious thoughts, more space to observe rather than react. There is no “right” way to experience ketamine. You’ll rest comfortably with an eye mask and carefully curated music to support an inward focus. Dr. Almeida remains present throughout.
A different kind of care. This is not a high-volume clinic model. Each session is private, physician-led, and intentionally structured. The emphasis is on preparation, presence, and integration—not speed. Some patients come seeking relief from symptoms. Others come sensing that their current way of relating to themselves no longer works. The practice is designed to hold both.
Clinical foundation. This work begins with medicine. Ketamine is administered within a structured clinical framework, with careful attention to safety, dosing, contraindications, and individual response. A background in emergency medicine informs a deep respect for physiology, pharmacology, and the need for calm precision.
Therapeutic orientation. Meaningful change rarely comes from biology alone. This approach is informed by Internal Family Systems, somatic awareness and nervous system regulation, and depth-oriented frameworks that help make sense of what emerges during altered states. These are not layered on as ideology—they are used selectively to help patients translate experience into understanding.
Ketamine opens a door; integration helps you walk through it. While the medicine can reveal important themes or perspectives, lasting change most often comes through reflecting on what emerged and thoughtfully carrying it into daily life. Integration often includes bringing previously unrecognized emotional material into awareness, allowing it to be met with understanding and compassion. After each session, key themes are summarized and personalized journaling prompts are offered. Ketamine-assisted therapy at Emergence Medicine is a physician-led medical service that includes preparation and integration support. It is not a substitute for ongoing psychotherapy with a licensed mental health provider.
Avoid eating for several hours before your session (water is fine). Limit fluids and reduce caffeine intake. Wear comfortable clothing. Most importantly, arrange transportation home—driving is not permitted until the following day. Before the session, time is spent helping your nervous system settle and clarifying intention through quiet reflection and grounding practices.
Ketamine is administered most commonly via intramuscular (IM) injection or intravenous (IV) infusion. In some cases, nasally administered Esketamine (Spravato) can be used. IV and IM routes have a more rapid onset and higher bioavailability, while the nasal route is more slowly absorbed with a lighter effect. The best approach for your treatment will be a collaborative decision made after appropriate evaluation.
Yes. Ketamine is an FDA-approved medication. Esketamine (Spravato) is specifically FDA-approved for treatment-resistant depression. IV and IM ketamine is considered off-label for many other uses and is supported by clinical research and accepted medical practice when prescribed and administered by a licensed clinician.
Spravato may be covered by your insurance plan in certain cases. Most insurance plans do not currently cover ketamine IV or IM therapy as much of its use is considered off-label. We can discuss payment options during your consultation and determine whether or not your insurance may provide partial or full coverage.
Many commonly used medications—including SSRIs, SNRIs, lithium, bupropion (Wellbutrin), and aripiprazole (Abilify)—can be continued with ketamine. Some medications may affect treatment, including higher doses of lamotrigine, benzodiazepines, stimulants, MAOIs, and other CNS depressants. Medications should never be adjusted or stopped without medical guidance. Dr. Almeida will review your full medication profile during consultation.
All clients complete an intake consultation and a comprehensive pre-medication visit. This includes a detailed review of medical and psychiatric history, current medications, and treatment goals. Time is taken to discuss risks, benefits, alternatives, and expectations so you can make an informed decision. There is no pressure or obligation. Informed consent is required prior to any treatment.
Ketamine may be administered alongside certain psychiatric medications; however, some medications can influence ketamine’s effects or safety profile. Medications that may affect treatment include, but are not limited to:
Many commonly used medications including SSRIs, SNRIs, lithium, bupropion (Wellbutrin), and aripiprazole (Abilify) can be continued with ketamine. Medications should not be adjusted or stopped without medical guidance. If appropriate, Dr. Almeida may recommend holding or modifying certain medications on treatment days.
Yes. Ketamine treatment is not appropriate in the presence of certain absolute contraindications, and may require additional evaluation in others.
Absolute contraindications include:
Conditions requiring additional evaluation:
This list is not exhaustive. Medical eligibility is determined on an individual basis following a comprehensive evaluation.
Common expected short-term effects:
Less common effects (typically transient):
Cardiovascular & respiratory: Temporary increases in blood pressure or heart rate may occur during treatment. At therapeutic doses, significant respiratory effects are uncommon.
With repeated or long-term use: Rare side effects may include bladder irritation (cystitis) or transient elevations in liver enzymes. These risks are monitored clinically.