DEPRESSION TREATMENT
Ketamine therapy is a treatment option for adults with depression who have not improved enough with traditional antidepressants. At Seaside Ketamine, we offer physician-supervised IV and IM ketamine therapy, along with FDA-approved Spravato® (esketamine) for eligible patients.
UNDERSTANDING KETAMINE
Ketamine therapy is a treatment approach that may help adults with depression, particularly those who have not responded adequately to conventional antidepressant medications.
Unlike traditional antidepressants, which primarily affect serotonin, norepinephrine, or related neurotransmitter systems, ketamine acts on the brain’s glutamate signaling system. This different mechanism is associated with antidepressant effects that can emerge more rapidly in some patients.
IV and IM ketamine are used off-label for depression, while Spravato® (esketamine) is FDA-approved for specific depression indications.
At Seaside Ketamine, we evaluate each patient’s treatment history, medical needs, and goals before recommending an approach.
UNDERSTANDING DEPRESSION
Depression is a complex condition involving changes in mood regulation, stress responses, brain signaling, and multiple biological and psychological factors. Although antidepressant medications and psychotherapy help many people, some continue to experience significant symptoms despite appropriate treatment.
For these patients, treatment-resistant depression may require a different approach. Ketamine and esketamine affect the glutamate system, offering treatment options that work differently from conventional antidepressants.
At Seaside Ketamine, we also consider factors that may influence mental health, including sleep, physical activity, nutritional status, metabolic health, medication effects, and relevant medical conditions. When appropriate, additional evaluation can help identify treatable problems that may be contributing to symptoms.
Our goal is to develop an individualized treatment plan grounded in established medical care while incorporating emerging research where appropriate.
You’ve tried SSRIs, SNRIs, maybe even augmentation strategies. The STAR*D trial found that after four rounds of medication trials, only about one third of patients achieve remission. Meanwhile, side effects grow: weight gain, sexual dysfunction, emotional blunting. There’s a reason you feel stuck — the standard approach is treating symptoms while missing the biological machinery driving them.
Your depression may be driven by insulin resistance (affecting up to 40% of depressed patients), chronic inflammation (elevated hs-CRP and IL-6), thyroid dysfunction, gut dysbiosis, vitamin D or B12 deficiency, magnesium depletion, or mitochondrial dysfunction. These aren’t fringe theories — they’re published in the world’s leading psychiatric journals. Yet most providers never test for them.
THE SCIENCE
Most conventional depression treatment focuses on symptom calming. While SSRIs can be helpful for some patients, they represent just one small piece of a much larger biological puzzle.
OUR FOUR-PHASE APPROACH
Ketamine Therapy (IV, IM, or Spravato) creates rapid neuroplasticity, breaking the rigid neural patterns of depression within hours to days rather than weeks to months.
Integration therapies to leverage the neuroplastic window created by ketamine and address psychological root causes.
We look beyond symptoms to identify medical, metabolic, and lifestyle factors that may contribute to depression.
Nutritional deficiencies
Hormonal imbalances
Metabolic health
Inflammation
Sleep and gut health
Stress and lifestyle factors
Testing is individualized based on each patient’s history and clinical needs.
Lifestyle medicine and ongoing support to build a life that sustains recovery.
YOUR TREATMENT OPTIONS
Not sure which option is right for you?
That’s exactly what the initial consultation is for. Dr. Gillin will review your history, goals, and preferences to recommend the best path forward.
| Feature | IV Ketamine | IM Ketamine | Spravato® |
|---|---|---|---|
| Administration | Intravenous infusion | Intramuscular injection | Nasal spray |
| FDA Approval for Depression | Off-label use | Off-label use | FDA-approved for specific depression indications |
| Medical Supervision | Supervised clinical treatment | Supervised clinical treatment | Direct supervision in a REMS-certified setting |
| Insurance Coverage | Typically self-pay | Typically self-pay | May be covered for eligible patients |
| Treatment Plan | Individualized based on clinical response | Individualized based on clinical response | Structured treatment schedule with ongoing assessment |
WHAT THE RESEARCH SHOWS
Research shows that ketamine can produce meaningful improvements in depressive symptoms for some patients who have not responded adequately to traditional antidepressants. Unlike conventional medications, which often take several weeks to work, ketamine may begin reducing depressive symptoms within hours to days.
Clinical studies of intravenous ketamine have reported antidepressant response rates of approximately 50–70% in selected patients with treatment-resistant depression. However, results vary depending on the study, patient population, and treatment protocol. Not everyone responds, and improvement after a single treatment may be temporary.
Repeated treatments may help some patients sustain improvement, although the optimal long-term approach remains an area of ongoing research. Spravato® (esketamine) has also demonstrated antidepressant benefits in clinical trials and is FDA-approved for specific depression indications.
At Seaside Ketamine, we assess your symptoms and treatment response throughout care to determine whether ketamine therapy is helping and whether continued treatment is appropriate.
YOUR TREATMENT EXPERIENCE
Ketamine treatment at Seaside Ketamine takes place in a comfortable, medically supervised setting. Each visit is designed around your safety, treatment goals, and individual response.
Before beginning treatment, we review your medical and psychiatric history, current medications, previous depression treatments, and overall health to determine whether ketamine is appropriate for you.
Your medical team develops an individualized treatment plan. Depending on your clinical needs, treatment may involve IV ketamine, IM ketamine, or Spravato® (esketamine).
During treatment, you’ll relax in a private treatment room while our clinical team monitors your blood pressure, vital signs, and response. Some patients experience temporary changes in perception or a sense of detachment during treatment.
After treatment, we’ll assess your recovery before discharge. You’ll need a responsible adult to take you home and should avoid driving until you’ve recovered according to your treatment-specific instructions. We also track your depression symptoms over time to evaluate your progress and guide future care.
FREQUENTLY ASKED QUESTIONS
Ketamine may begin improving depressive symptoms within hours to days, which is faster than many conventional antidepressants. Some patients notice changes after their first treatment, while others improve later in a treatment series. Not everyone responds, and the timing and degree of improvement vary.
Clinical studies have found that intravenous ketamine can produce meaningful improvement in some patients with treatment-resistant depression, including people who have not responded adequately to conventional antidepressants. Response rates vary across studies and treatment protocols. Improvement is not guaranteed, and ongoing assessment helps determine whether treatment is beneficial.
The number of treatments depends on the type of ketamine therapy, your diagnosis, and your response. IV and IM ketamine plans are individualized, while Spravato follows a structured treatment schedule. We evaluate your progress throughout treatment and discuss whether additional sessions or maintenance care may be appropriate.
IV and IM ketamine are not FDA-approved for depression and are prescribed off-label. Spravato® (esketamine), a related medication administered as a nasal spray, is FDA-approved for treatment-resistant depression in adults and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. Spravato has specific treatment and monitoring requirements.
Many patients continue their existing antidepressants while receiving ketamine therapy. However, certain medications may affect treatment safety or response, so we review your complete medication list before starting. Any changes should be coordinated with your prescribing clinician. Spravato can be used alone for treatment-resistant depression or with an oral antidepressant, depending on the indication and treatment plan.
The duration of improvement varies considerably. Some patients experience relief for days or weeks after treatment, while others may benefit from additional sessions or maintenance treatment. We monitor symptoms over time and discuss strategies for sustaining improvement, including appropriate psychiatric care, psychotherapy, and lifestyle support.
Possible side effects include temporary dissociation, dizziness, nausea, sedation, changes in perception, and increased blood pressure. Ketamine also carries risks related to misuse and repeated exposure. At Seaside Ketamine, we evaluate medical and psychiatric history before treatment and monitor patients during their visits. Treatment is not appropriate for everyone.
Insurance coverage depends on the treatment and your individual plan. IV and IM ketamine for depression are generally self-pay because their psychiatric use is off-label. Spravato may be covered by commercial insurance or Medicare for eligible patients, often with prior authorization. Our team can help verify your benefits and explain expected costs before treatment begins.
Ketamine and transcranial magnetic stimulation (TMS) are different approaches to treating depression. Ketamine is a medication that acts on the brain’s glutamate system, while TMS uses magnetic pulses to stimulate specific brain regions. TMS is FDA-cleared for certain depression indications, and both treatments may be considered when conventional approaches have not provided adequate relief. The best option depends on your diagnosis, treatment history, medical needs, and preferences. Learn more here.
Ketamine may not be appropriate for patients with uncontrolled hypertension, certain cardiovascular conditions, active psychosis, or other medical or psychiatric concerns. A history of substance misuse also requires careful evaluation. Eligibility depends on the treatment being considered, and Spravato has additional FDA-listed contraindications. We review these factors during your medical assessment.
Not everyone responds to ketamine, and a lack of improvement should prompt reassessment rather than automatically continuing treatment. We may review your diagnosis, medications, sleep, medical conditions, and other factors affecting your symptoms. Depending on your situation, other treatments such as TMS, ECT, psychotherapy, or medication changes may be appropriate.
If you’ve tried medications and therapy without lasting relief, there’s a better path forward. The first step is a free 30-minute call with our team.
