Ketamine & Spravato

Rapid-acting treatment for depression in Denver, CO

Relief in days, not weeks
Delivered and monitored by psychiatrists
For depression that hasn't lifted

4.7 from 37 Google reviews

$ 0

Initial visit, incl. first treatment

$ 0

Per follow-up treatment

0

Board-certified psychiatrists

0

Treating patients in Denver since

The short version

Ketamine & Spravato, in brief

What it is

Rapid-acting treatment for depression, overseen by a psychiatrist.

What happens
You’re monitored in a calm treatment room throughout, with a therapist present if you choose ketamine-assisted therapy. You’ll need someone to drive you home.
Who it’s for

Adults whose depression hasn’t improved on two or more antidepressants, or who chose not to take standard antidepressants.

Cost
Ketamine: $360 initial visit including your first treatment, $250 per follow-up treatment.
Note
Insurance does not cover ketamine. Spravato may be covered - we’ll tell you where you stand on your call.

The TREATMENT

What are ketamine and Spravato?

Both work on a different brain system than standard antidepressants, which is why they can help when other medications haven’t, and why they can work in days rather than weeks. Spravato (esketamine) is an FDA-approved nasal spray given in-clinic. Ketamine is given by infusion or injection. Both are delivered in a calm, monitored setting, and neither is something you take home.

How does it work?

Standard antidepressants take several weeks to work and sometimes months to reach the full benefit. Ketamine and esketamine act on glutamate and the NMDA receptor, helping the brain rebuild connections involved in mood. This is why they are associated with a rapid response rate, with many people noticing a shift within one to two weeks, far sooner than a new antidepressant. It doesn’t work for everyone, and your psychiatrist will review your response after the first few treatments before planning further.

Suitability

Who can it help

It could be a good fit if
  • Two or more antidepressants haven’t given you a lasting result.
  • Your depression came on fast or feels urgent.
  • You want an option that can work in days, not weeks.
  • Medication helps, but not enough.
  • You can arrange a ride home after each visit.
We'd check carefully if
  • Whether you have uncontrolled high blood pressure.
  • Whether you have a history of psychosis.
  • Whether there’s a history of substance misuse to weigh up.

It isn’t right for everyone. We check all of this before anything is booked, and if it isn’t the right treatment for you, we’ll say so.

What happens

Your course, start to finish

The free call


We take a few details, then a psychiatrist calls you back, usually within 24 hours. Ten minutes on what you’ve tried and whether ketamine or Spravato is worth pursuing.

Evaluation


A full psychiatric evaluation confirms you’re a candidate and checks your history and blood pressure. Your psychiatrist talks you through which of the two treatments fits, and what to expect.

Your session


You’re in a calm, private room, monitored by clinical staff throughout. The experience can feel unusual for a short while and settles before you leave. You’ll need someone to drive you home.

Follow-up


Your psychiatrist reviews how you’re responding and adjusts the plan, including whether ongoing maintenance treatments make sense for you.

The equipment

Two treatments, one conversation

We offer both Spravato and ketamine. Which one fits you depends on more than a checklist can capture - your history, your goals, how each is given, and what your insurance allows all play a part. Rather than having you weigh that up from a webpage, your psychiatrist talks it through with you and helps you choose the right one.

AN ADDED OPTION

Ketamine-assisted therapy

If you choose it, a therapist can be in the room with you during treatment, so the experience is used as an opportunity for guided reflection rather than something you simply sit through. It isn’t required, and your psychiatrist will talk you through whether it suits you.

PRICING

What it costs

Clear on cost, before you commit.

Ketamine treatment Price
Initial comprehensive evaluation, including your first treatment
$360
Each follow-up treatment
$250

Insurance: Ketamine treatments are not covered by insurance. Spravato may be covered, and credentialing is in progress, ask on your call and we'll tell you exactly where it stands.

Questions

What do people ask before they call

Straight answers to the questions we hear most.

  • How soon might I feel better?

    Many people notice a shift within one to two weeks, far sooner than a new antidepressant. It doesn’t work for everyone, and your psychiatrist will review your response after the first few treatments before planning further. We recommend discussing the choice between ketamine and Spravato with your provider during your consultation, as there are complex differences to consider.

  • Do you take my insurance?

    Not for ketamine - it isn’t covered anywhere, so it’s self-pay. Spravato may be covered, and we’re working through credentialing. Say so on your call and we’ll tell you where things stand.

  • Is it safe? What does it feel like?

    Both are given under clinical monitoring. The experience can feel unusual for a short while - a floaty or dream-like feeling is common - and it settles before you leave. Because of that, you can’t drive afterwards and will need a ride home.

  • Will I need to stop my medication?

    Usually not. Most people continue their existing medication, and any changes are made by your psychiatrist as part of the evaluation.

  • Can a therapist be present during treatment?

    Yes. We offer ketamine-assisted therapy, where a therapist is in the room with you during treatment to help you make use of the experience. It’s optional, and your psychiatrist will discuss whether it fits your goals.

  • What's the difference between ketamine and Spravato?

    The two suit different people, and the reasons are more nuanced than a quick summary does justice. That's a conversation to have with your psychiatrist, who'll weigh your history and your preferences and recommend the one that fits. Both work quickly and both are given under monitoring here.

  • How many treatments will I need?

    It varies. Many people start with a short series of treatments close together, then move to occasional maintenance if it’s helping. Your psychiatrist plans this around your response rather than a fixed number.

  • Can I drive myself home?

    No. You’ll need someone to drive you home after each treatment. Plan for that when you book.

  • What if it doesn't work for me?

    It doesn’t work for everyone, and we’d rather say that plainly. The free call and the evaluation exist to filter out people who aren’t good candidates first. If it isn’t right, we’ll talk you through the other options here, including TMS and medication management.

Why us

Real doctors, for whatever you’re facing

Two board-certified psychiatrists and a whole practice behind your care, whichever treatment brings you in.

All ages

Children, adults, and teenagers seen by a specialist.

Physician led

board-certified psychiatrist, not a technician or NP.

Seen quickly

A psychiatrist calls back within 24 hours.

Clear on cost

You'll know the cost before you commit.

Care that adapts

The right treatment for you, from a full range.

Whole-picture care

Depression, anxiety, ADHD and addiction, one practice.

Who treats you

Board-certified psychiatrists. One of them will evaluate you and oversee your course personally.

Dr. Charles Shuman, Founder · Psychiatrist

Dr. Charles Shuman

Founder · Psychiatrist

Trained at Temple University, the University of Florida and the University of Colorado, where he has also taught on the faculty. Founded Confluence in Denver in 2016.

Dr. Shankar Nandakumar, Psychiatrist

Dr. Shankar Nandakumar

Psychiatrist

Fellowship-trained in child and adolescent psychiatry, and leads adolescent care at the practice.

What patients say

The Confluence difference

Where the difference actually shows.

Other clinics
Speaking to a doctor
Before you schedule
After you've booked
Evaluation
Board-certified psychiatrist
Often an NP or PA
Who you see next time
The same psychiatrist
Whoever's available
If it stalls
Your doctor adjusts it
Escalated, if anyone's free

Find out whether ketamine or Spravato is right for you

Ten minutes with a psychiatrist. No charge, no commitment, and an honest answer either way.