Quick Answer: Ketamine-assisted therapy combines a low-dose ketamine treatment with psychotherapy. It's mainly used for adults whose depression hasn't improved enough with other treatments. At Confluence Psychiatry, you start with a free 10-minute call and a full evaluation with a psychiatrist , and you can choose to have a therapist in the room during treatment. Below is what happens before, during, and after a session, and what it costs. If you've tried more than one antidepressant and you're still struggling, you've probably read about ketamine. Much of what's online either oversells it or makes it sound frightening. This guide explains what ketamine-assisted therapy at our Denver office actually involves. What Is Ketamine-Assisted Therapy? Ketamine has been used as an anesthetic for decades. At much lower doses, it has been studied as a treatment for depression, particularly depression that hasn't responded to standard medications. Most antidepressants take weeks to work. Ketamine acts on a different brain chemical system, glutamate, and it's associated with a rapid response. Some people notice a change within hours or days. Individual responses vary, and it doesn't work for everyone. Ketamine-assisted therapy pairs the treatment with psychotherapy. At Confluence, a therapist can be with you in person during the treatment. Ketamine can loosen stuck patterns of thinking for a short time, and a therapist helps you make use of that time. Ketamine is FDA-approved as an anesthetic, and its use for depression is off-label. Esketamine (Spravato), a related nasal spray, is FDA-approved for treatment-resistant depression. We offer both. Learn more about ketamine and Spravato at Confluence. Who Is It For? Ketamine is usually considered for adults with treatment-resistant depression , which means depression that hasn't improved enough after trying other treatments. It isn't a first-line option. It may not be suitable if you have: Uncontrolled high blood pressure or certain heart conditions A history of psychosis A current pregnancy A history of substance misuse that hasn't been addressed The evaluation is where we work through these questions. Dr. Charles Shuman is board-certified in addiction psychiatry, so questions about substance use history are reviewed by a specialist. What Happens Before Your First Treatment? A free 10-minute call. Speak with one of our physicians, ask your questions, and find out whether an evaluation makes sense. There's no obligation. A comprehensive evaluation. You'll meet with a psychiatrist, a medical doctor with specialist training in psychiatry. We'll review: Your symptoms and how long they've lasted The medications and therapies you've already tried Your medical history, current medications, and blood pressure Any history of substance use If ketamine is a good fit, the evaluation fee includes your first treatment. If it isn't, we'll say so and talk through other options, such as TMS , Spravato, or changes to your medication plan.