Psychiatric Care · Intranasal Esketamine (Spravato®) · IV Ketamine

Ketamine Treatment

Published: August 1, 2026 Reviewed by: Brandon Stutz,PA-C, CAQ-Psych

For some patients, standard antidepressants and traditional treatment approaches do not provide adequate symptom relief. Ketamine-based therapies have emerged as an important option for individuals who continue to struggle with depression despite multiple treatment attempts.

PNS offers both FDA-approved intranasal esketamine (Spravato®) and IV ketamine for qualifying patients. These treatments work differently than traditional antidepressants and may provide new possibilities for individuals experiencing treatment-resistant depression and related mood disorders.

Innovative treatment options for patients who have not found sufficient relief through traditional approaches.

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Ketamine treatments are administered at PNS locations and we are in-network with most major insurance plans.

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At PNS, treatment is guided by experienced psychiatric providers who evaluate each patient’s history, symptoms, and goals to determine whether ketamine-based treatment may be appropriate. Depending on individual circumstances, patients may qualify for either intranasal esketamine (Spravato®) or IV ketamine.

What is ketamine treatment?

Ketamine-based treatments represent a different approach to treating depression and certain mood disorders.

Unlike traditional antidepressants, which primarily affect serotonin and related neurotransmitters, ketamine-based treatments act on glutamate pathways within the brain. Researchers believe these pathways play an important role in mood regulation, neuroplasticity, and the brain’s ability to form and strengthen neural connections.

PNS offers two ketamine-based treatment options for qualifying patients. While both treatments utilize related compounds, they differ in administration, eligibility requirements, and insurance considerations.

Both approaches may be considered when symptoms persist despite previous treatment efforts.

Intranasal Esketamine (Spravato®)

Esketamine (Spravato®) is an FDA-approved prescription nasal spray for adults with treatment-resistant depression. It can be used on its own or, most commonly, in combination with an oral antidepressant.

Treatment is administered in-office under medical supervision and follows a structured schedule designed to support symptom improvement over time.

Because esketamine is FDA-approved, insurance coverage may be available for qualifying patients depending on plan requirements.

IV Ketamine

IV ketamine treatment delivers ketamine intravenously in a monitored clinical setting, allowing providers to precisely control dosing throughout treatment. This approach may be considered for patients who have not experienced sufficient relief through traditional treatment options and are seeking an alternative path forward.

Unlike esketamine (Spravato®), IV ketamine is not covered by insurance and is offered as a cash-pay service.

How It Works

A comprehensive evaluation comes first

Every patient begins with a psychiatric assessment designed to determine whether ketamine-based treatment may be appropriate. Treatment recommendations are individualized and based on a thorough clinical review.

Your provider will evaluate:

  • Current symptoms
  • Psychiatric and medical history
  • Previous medications and treatments
  • Treatment goals
  • Overall eligibility

What to expect

Initial Consultation

Your provider reviews your symptoms, treatment history, and treatment goals to determine whether ketamine-based therapy is appropriate.

Treatment Sessions

Treatments are administered in-office under medical supervision. Patients remain monitored throughout treatment and for a period afterward to ensure safety and comfort.

Ongoing Follow-Up

Progress is evaluated regularly and treatment plans are adjusted when necessary. Ketamine-based therapies are often incorporated into a broader treatment plan.

Who qualifies?

Ketamine-based treatment may be considered for individuals who:

  • Have treatment-resistant depression
  • Have not responded adequately to multiple antidepressants
  • Continue experiencing significant symptoms despite treatment
  • Are 18 years or older

Not every patient is a candidate for TMS, and treatment recommendations are based on individual clinical circumstances.

Insurance and costs

Coverage depends on the specific ketamine treatment being provided.

Esketamine (Spravato®) may be covered by insurance for qualifying patients. Coverage requirements vary by insurer and often require documentation of previous treatment history.

IV ketamine therapy is offered as a cash-pay service at a rate of $350 per session, and is not billed through insurance.

Our team can help review treatment options, verify benefits, and discuss costs before treatment begins.

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See if ketamine treatment is right for you

Book an appointment at a PNS location that offers this treatment. Our team will confirm availability and verify your insurance before your first visit.

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Our Locations

PNS locations offering
ketamine treatment

Ketamine therapy services are available at multiple PNS locations throughout Southern California.

Advancing care through clinical research

PNS was among the early adopters of intranasal esketamine (Spravato®) following its 2019 FDA approval and has extensive clinical experience with esketamine treatment in Southern California. Our providers follow the ketamine research literature closely and maintain current knowledge of evolving protocols, maintenance strategies, and patient selection criteria.

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FAQs

Frequently Asked Questions

Spravato® is an FDA-approved nasal spray containing esketamine that is administered under medical supervision in a certified treatment setting. IV ketamine therapy uses ketamine delivered intravenously in a monitored clinical environment. While both treatments affect similar pathways in the brain, they differ in administration, eligibility requirements, and insurance coverage.

Many patients notice improvement in depressive symptoms within 24 hours of their first treatment. Some experience relief even during or shortly after their first session. The speed of onset is one of ketamine’s most meaningful clinical advantages over traditional antidepressants.

Response duration varies. Following a standard esketamine induction course, many patients transition to maintenance dosing (once every 1–2 weeks) to sustain response. IV ketamine response typically lasts days to weeks, with maintenance infusions used as needed. Your PNS provider will work with you to develop an appropriate maintenance plan.

Ketamine has a potential for misuse, particularly at high doses. In clinical use at therapeutic doses and under medical supervision, the risk of developing a use disorder is considered low. PNS screens patients carefully before initiating treatment and monitors throughout. The controlled, supervised clinical setting is specifically designed to minimize misuse risk.

Ketamine can produce dissociative effects — a feeling of being detached from your surroundings or your body — during and shortly after administration. These effects are temporary and expected. They are part of why patients are monitored for 2 hours after esketamine and are observed throughout IV ketamine infusions. The experience is generally manageable and resolves before you leave the clinic.

Yes. Ketamine-based therapies are often incorporated into broader treatment plans that may include medication management, psychotherapy, or other psychiatric services. This includes existing antidepressants, as esketamine is specifically FDA-approved for use in conjunction with an oral antidepressant. Your PNS provider will review your current medications for any relevant interactions before starting treatment.

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