Ketamine therapy has been available as a treatment option for several years now, but most of what people find when they search for it is either a clinical overview that reads like a textbook or a promotional page from an infusion clinic focused on the experience rather than the medicine. This article is written from a psychiatric standpoint, for people who are considering ketamine therapy and want to understand what it involves before they make a decision.
Sage Psychiatry Services offers ketamine therapy in Colorado Springs Monday – Friday, administered in-office to patients who have completed a clinical evaluation and been determined to be appropriate candidates. It is not available via telehealth, and it is not offered at our Montana locations. It is one of the more involved treatment options we provide, and that is exactly why we approach it carefully.
Who Ketamine Therapy Is For
Ketamine therapy is not a first-line treatment, and at Sage, we do not position it as one. It is appropriate for patients with treatment-resistant depression, which typically means depression that has not responded adequately to at least two different antidepressant medications tried at appropriate doses and for appropriate durations. It is also used for treatment-resistant PTSD and, in some cases, severe or rapidly cycling mood symptoms.
Patients who come to us for ketamine evaluation often have years of psychiatric history behind them. They have tried SSRIs, SNRIs, and sometimes augmentation strategies. Some have been through multiple medication trials with a previous provider and reached a point where standard options feel exhausted. Others have had partial responses, meaning the medication helped somewhat but never got them where they needed to be.
If you are in that position, ketamine is worth a thorough conversation. If you are earlier in your treatment history, we will typically recommend working through other options first.
How Ketamine Works Differently from Standard Antidepressants
Most antidepressants, including SSRIs and SNRIs, work by changing the availability of serotonin, norepinephrine, or dopamine in the brain. They take weeks to build up to therapeutic levels, and for many patients, they never fully get there.
Ketamine works through a different mechanism entirely. It acts primarily on NMDA receptors, which are glutamate receptors involved in synaptic plasticity, and it triggers a rapid release of brain-derived neurotrophic factor, a protein that supports the growth and repair of neural connections. The clinical result for many patients is a rapid reduction in depressive symptoms, often within hours to days of a session rather than weeks.
This does not mean ketamine replaces other psychiatric care. For most patients, it works best as part of a broader treatment plan that includes ongoing medication management and, where appropriate, therapy. What it offers is a faster path to symptom relief while longer-term stabilization is being worked out, and for patients who have been in a depressive episode for months or years, that speed matters.
The National Institute of Mental Health has described ketamine as one of the most significant advances in depression treatment in decades, and the research supporting its use in treatment-resistant depression is among the strongest in psychiatric medicine. The FDA-approved esketamine nasal spray (Spravato) is a derivative compound that follows the same basic mechanism.
What a Ketamine Session at Sage Psychiatry Looks Like
Before any session takes place, every patient goes through a clinical evaluation. This is not a brief intake form. We review your psychiatric history, your current medications, any prior treatment trials, your medical history, and any factors that would either support or complicate ketamine treatment. The evaluation determines whether ketamine is appropriate, what the initial dosing approach should be, and what the monitoring plan will look like.
Ketamine sessions at Sage are held Monday-Friday at our in-office Colorado Springs location. The administration route and specific session structure are determined during your evaluation and depend on your clinical picture. The first session is 2 hours in the office, and follow-up sessions are 90 minutes, pending the individual is able to tolerate the treatment. Sessions typically run between 45 minutes and several hours depending on the protocol. You will need a responsible adult over the age of 18 to drive you home after each session. We also advise that for the 12 hours post treatment you do not drive, operate heavy machinery, or make major decisions until the effects of the ketamine wear off.
All other psychiatric services at Sage, including evaluation, medication management, and follow-up care, are available via telehealth for patients throughout Colorado and Montana. Ketamine is the one exception that requires an in-person visit.
Treatment begins with an initiation period, which entails a session 2 times a week for 3 weeks. The first session will be around 2 hours and follow-up sessions are 90 minutes, pending the patient is able to tolerate treatment. We monitor your response throughout, adjust the approach if needed, and maintain contact between sessions to track how you are feeling.
Colorado Springs summers are busy, and if you are managing depression that has not responded to prior treatment, the gap between wanting help and knowing where to start can be significant. A consultation at Sage is the place to start.
Is Ketamine Therapy Right for You?
The patients who tend to do well with ketamine share a few things in common. They have a documented history of treatment resistance, meaning prior medications either did not work or produced side effects that were not manageable. They are stable enough to engage with the process safely, meaning they are not in acute crisis that requires a higher level of care. And they are prepared for the possibility that ketamine helps but does not eliminate the need for other ongoing psychiatric management.
Ketamine is not appropriate for patients with a personal or family history of psychosis or certain cardiac conditions, and there are specific contraindications we review during the evaluation. It is also not appropriate as a standalone treatment pursued independently of broader psychiatric care. At Sage, ketamine is offered within a psychiatric relationship, not as a standalone service.
If you are unsure whether you qualify, the evaluation is the right next step. We will give you a direct answer.
What Happens After a Ketamine Session
The effects of ketamine during a session are temporary, and the goal is for those effects to set in motion changes in brain function that persist after the drug itself has cleared. For many patients, mood improvement begins within a day or two of the first session and builds through the initial course. For others, the effect takes longer to develop or requires dose adjustment.
After the treatment initiation period, the patient’s condition will be reevaluated, and then a treatment plan will be discussed. Some patients need a session every few weeks, others every few months.
The question we hear most from patients considering ketamine is whether it will work for them specifically. There is no honest answer to that before the evaluation, because the factors that predict response are individual. What we can tell you is that among patients with documented treatment-resistant depression, response rates in the clinical literature are significantly higher than for additional antidepressant trials, and the onset of response is faster. Those are not guarantees, but they are meaningful numbers for someone who has been through several years of treatment that did not work well enough.
Frequently Asked Questions About Ketamine Therapy
How many ketamine sessions are typically needed?
Patients should expect the treatment initiation period to include 2 sessions a week for 3 weeks to begin. Maintenance sessions after the initial course vary significantly by patient. We will discuss what the plan looks like specifically for you before treatment begins.
Is ketamine therapy covered by insurance in Colorado?
Ketamine is not a service currently covered by insurance. Each session is $300 and our practice does offer Care Credit. We will review your specific situation during the evaluation and be upfront about costs before any treatment begins.
Can I drive after a ketamine therapy session?
No. You will need a driver. The dissociative effects of ketamine make it unsafe to drive for the rest of the day following a session, and we will not proceed with treatment if you do not have transportation arranged.
What is the difference between ketamine infusion and esketamine (Spravato)?
Ketamine infusions use racemic ketamine administered intravenously. Spravato is esketamine, a derivative compound, administered as a nasal spray in a supervised clinical setting. Both act on NMDA receptors and have demonstrated efficacy in treatment-resistant depression. The administration route, insurance coverage, and specific protocols differ. We will explain which approach applies at Sage during your evaluation.
Does Sage Psychiatry offer ketamine therapy for PTSD, not just depression?
Yes. Ketamine has evidence supporting its use in treatment-resistant PTSD, and we evaluate patients with PTSD as potential candidates. The evaluation process is the same, and candidacy depends on your specific clinical picture.
How do I know if I am a candidate for ketamine therapy?
The evaluation determines candidacy. General indicators include a documented history of inadequate response to at least two antidepressant medications, absence of contraindications such as certain cardiac conditions or history of psychosis, and stability appropriate for outpatient treatment. If you are unsure, the most direct path is to contact us to schedule an evaluation.
If ketamine therapy is something you have been wondering about, the conversation starts with a clinical evaluation at Sage Psychiatry Services. You can learn more about our full range of psychiatric treatments in Colorado Springs, including how we approach treatment-resistant depression and PTSD care for patients who have not found adequate relief elsewhere.
