Ketamine therapy is a medically supervised outpatient treatment option available at San Diego Transformation Center for individuals with treatment-resistant depression and certain chronic pain conditions.
This guide explains what ketamine therapy involves, how it may help, and what to expect during evaluation and treatment.
Ketamine therapy uses controlled, clinical doses of ketamine or the related drug esketamine to affect brain systems involved in mood regulation and pain processing.
How It Works for Depression:
In depression, ketamine and esketamine act on glutamate signaling and synaptic connectivity. This mechanism can reduce depressive symptoms more rapidly than many traditional antidepressants for some people.
How It Works for Pain:
For chronic neuropathic or complex regional pain conditions, ketamine can modulate:
Important Considerations: Statements about likely benefit should be individualized and discussed with a clinician, since responses vary.
Ketamine therapy is considered for individuals experiencing:
Clinical assessment determines whether ketamine is appropriate given diagnosis, history, concurrent treatments, and medical status.
People in San Diego and surrounding areas seeking treatment for depression or chronic pain may find that traditional therapies have provided limited relief. Ketamine therapy offers an option for those who have not responded adequately to:
Structured outpatient ketamine treatment is coordinated with mental health programs such as a Partial Hospitalization Program (PHP) and Intensive Outpatient Program (IOP) when appropriate. This coordination supports continuity of care while individuals maintain their daily responsibilities.
Evaluation by a medical or psychiatric provider familiar with ketamine protocols helps determine clinical suitability and coordinates treatment with existing care plans.
San Diego Transformation Center provides medically supervised ketamine therapy with comprehensive safety screening, monitoring, and individualized treatment planning. Our approach includes clinical evaluation, informed consent, and coordination with concurrent mental health or substance use programming when appropriate.
Administration Methods:
Infusions are administered through an intravenous line, allowing precise dosing and continuous monitoring of vitals and mental status during the treatment. Infusions typically take 40 to 90 minutes depending on the protocol.
Intramuscular injections deliver a measured dose with shorter administration time than many IV infusions and are sometimes used when IV access is impractical.
Esketamine is an FDA-approved intranasal formulation delivered under a Risk Evaluation and Mitigation Strategy program that requires administration in a certified clinic and observation for at least two hours after dosing.
Treatment at San Diego Transformation Center follows a structured process that assesses needs, develops an individualized plan, provides ongoing support, and prepares for long-term stability.
Your initial evaluation includes:
Telehealth Options
Initial consultations are often available via telehealth when clinically appropriate and when state and licensing rules permit.
A virtual consultation can cover:
Certain in-person evaluations or testing may still be required prior to administration.
Treatment Planning Addresses:
IV Protocols commonly include:
IM Protocols commonly include:
Maintenance needs vary widely. Common approaches include:
Duration of Benefit:
Maintenance Decisions Balance:
Long-term planning includes ongoing monitoring of symptom response and functional status, coordination with outpatient mental health programming such as PHP or IOP, adjustment of maintenance frequency based on relapse prevention needs, and integration with existing medication management and psychotherapy.
Understanding maintenance helps inform expectations and coordination with outpatient programs when appropriate.
Common Side Effects (typically transient)
Less Common Concerns (with repeated high-dose or long-term recreational use)
Serious adverse events are uncommon in monitored medical settings.
Safety Screening Includes:
Monitoring during and after treatment reduces risk.
Timeline for Symptom Improvement:
IV/IM Ketamine:
Spravato (Esketamine):
Speed of response varies by person and condition. Not everyone experiences meaningful benefit. Rapid changes should be monitored closely, and treatment plans adjusted based on response and side effects.
Eligibility includes:
Common contraindications:
Liver and renal function are reviewed. Final determination follows comprehensive medical and psychiatric evaluation.
Typical Costs:
Our team can assist with benefits verification and prior authorization.
Insurance Coverage: Spravato is FDA-approved and more commonly covered. IV and IM ketamine are often off-label and may not be covered by all payers. Many clinics offer self-pay packages, sliding scales, and payment plans.
Kaiser Permanente: San Diego Transformation Center does not currently have a standing contract with Kaiser for ketamine therapy. Contact your Kaiser representative and our team for up-to-date information.
Financial Assistance: Veterans, first responders, and healthcare workers should contact our admissions team to discuss potential discounts and sliding scale options.
San Diego Transformation Center provides ketamine therapy as part of a structured outpatient care continuum. Our approach emphasizes:
Treatment for co-occurring mental health and substance use conditions requires careful evaluation; ambulatory detox and integrated outpatient programming can support coordinated care when appropriate.
San Diego Transformation Center provides ketamine therapy services to individuals in:
Ketamine therapy uses controlled, clinical doses of ketamine or the related drug esketamine to modulate glutamate signaling and synaptic function in the brain. This action can produce relatively rapid antidepressant effects for some people, particularly those who have not responded to standard antidepressants. Response is variable and requires medical assessment and monitoring.
Ketamine can be given intravenously, intramuscularly, or as intranasal esketamine (Spravato). IV allows precise dosing and continuous monitoring. IM is an injectable alternative with different pharmacokinetics. Spravato is an FDA-approved intranasal formulation that must be administered in a certified clinic with post-dose observation.
Typical induction varies by modality. IV induction commonly involves about 4 to 6 infusions over 2 to 3 weeks. IM induction schedules vary but often occur across 1 to 3 weeks. Spravato induction frequently follows a twice-weekly schedule for four weeks. Protocols are individualized based on response and tolerability.
Maintenance schedules are individualized. Many people receive booster treatments every 2 to 4 weeks, while others may require more or less frequent dosing based on symptom return. Duration of benefit varies from weeks to months; some people need ongoing maintenance to sustain improvements.
Ketamine therapy is generally safe when provided in a medical setting with appropriate screening and monitoring. Expect transient effects such as dissociation, nausea, dizziness, headache, and temporary increases in blood pressure. Serious events are uncommon in monitored settings. Screening for cardiovascular disease, psychosis, pregnancy, and substance use is standard.
Some people notice improvement within hours to days after an IV or IM session. Spravato may show effects within days to weeks in clinical trials. Individual response times vary, and not everyone benefits.
Ketamine is used for certain chronic pain conditions including CRPS, neuropathic pain, and refractory fibromyalgia. It is also used in select cases for bipolar depression, PTSD treatment, and severe anxiety when other treatments have been inadequate, always with careful clinical oversight.
Coverage varies. Spravato often has better insurance coverage due to FDA approval. IV and IM ketamine for depression are frequently considered off-label and may not be covered. Clinics commonly provide self-pay options, packages, sliding scale consideration, and assistance with prior authorizations. Verify benefits before starting treatment.
San Diego Transformation Center does not currently list a contract with Kaiser Permanente for ketamine therapy referrals. Insurance partnerships change over time, so contact both Kaiser and our team to confirm current referral and coverage pathways.
Discounts and financial assistance vary. Contact our admissions team to discuss potential discounts, sliding scale options, or payment plans available to veterans, first responders, or healthcare workers.
Initial consultations are often available via telehealth when clinically appropriate and allowable by licensure. Telehealth can handle history-taking, medication review, and initial screening, though some in-person assessments may still be required before treatment.
Common indications include complex regional pain syndrome (CRPS), refractory neuropathic pain, and some cases of fibromyalgia or phantom limb pain when other therapies have not provided adequate relief. Treatment is individualized and often coordinated with other pain specialists.
IV and IM ketamine are used off-label for depression and some pain conditions and can provide rapid effects, with similar side effect profiles of transient dissociation and hemodynamic changes. Spravato is FDA-approved for treatment-resistant depression, has a REMS program requiring clinic observation, and is more likely to receive insurance coverage. Each option requires different monitoring and has different logistical and coverage implications.
If you are exploring ketamine therapy or want to understand how it could work alongside structured outpatient care, speak with our team to review clinical suitability, verify insurance benefits, and discuss scheduling and costs. Contact us to start a benefits check or to arrange an initial consultation so you can make an informed decision about next steps.
