Modern treatments
Ketamine therapy for depression: Cost, clinics, and what to expect
Ketamine therapy has moved from experimental to mainstream for treatment-resistant depression. In 2026, thousands of ketamine clinics operate across the United States, with wide variation in quality, cost, and approach. This guide helps you navigate the landscape.
Two forms of ketamine treatment
IV ketamine infusions are administered intravenously in a clinical setting over 40-60 minutes. This is the most studied form and produces the most consistent results. It is used off-label for depression (not FDA-approved specifically for this indication). A typical course is 6 infusions over 2-3 weeks. Esketamine (Spravato) is an FDA-approved nasal spray containing the S-enantiomer of ketamine. It must be administered in a certified healthcare setting with 2 hours of post-administration monitoring. It is approved specifically for treatment-resistant depression and major depressive disorder with suicidal ideation.
What it costs
IV ketamine infusions typically cost $400-$800 per session, with a standard 6-session course totaling $2,400-$4,800. This is almost always out-of-pocket, as most insurance plans do not cover IV ketamine for depression. Esketamine (Spravato) is more likely to be covered by insurance because it is FDA-approved. With insurance, copays may range from $10-$150 per session. Without insurance, Spravato can cost $600-$900 per session. Maintenance sessions (typically monthly after the initial course) add ongoing costs of $400-$800 per month for IV ketamine or insurance copays for Spravato.
How to evaluate a ketamine clinic
The ketamine clinic landscape ranges from rigorous medical practices to questionable cash-pay operations. Look for a clinic supervised by a board-certified psychiatrist or anesthesiologist, that conducts a thorough psychiatric evaluation before treatment (not just a brief intake form), that provides ongoing psychiatric care and therapy alongside ketamine (ketamine alone is not a complete treatment), that has emergency protocols and monitoring equipment, and that does not make unrealistic promises about cure rates.
What a session looks like
For IV ketamine, you arrive at the clinic, are seated in a comfortable recliner, and an IV is started. The infusion runs over 40-60 minutes. During the infusion, you may experience dissociation, visual disturbances, floating sensations, and altered perception. A clinician monitors your vital signs throughout. After the infusion, you rest for 30-60 minutes until effects subside. You cannot drive yourself home. Many patients report mood improvement within hours to days of the first infusion, though full response often requires the complete 6-session course.