At-home ketamine FAQ

Yes. Ketamine is a Schedule III controlled substance that licensed prescribers in Michigan can prescribe off-label for depression, anxiety and PTSD. It has to be prescribed after a proper evaluation and dispensed by a licensed pharmacy, which is exactly how our program works.

Ketamine has misuse potential, which is why we screen for substance use disorders, prescribe limited quantities, keep doses conservative and monitor closely. Used as prescribed in a supervised program, the risk is low, but it is not zero, and we take it seriously.

During a session: dissociation (feeling detached or dreamlike), dizziness, nausea, blurred vision and a temporary rise in blood pressure. These usually pass within an hour or two. With frequent or high-dose use over time, ketamine can irritate the bladder; conservative dosing and regular check-ins are how we guard against that.

No. Plan not to drive, operate machinery, work, or make important decisions for the rest of the day.

Yes. We require a trusted adult in the home during each dosing session, at least for the first several sessions and ideally throughout.

Some do. Benzodiazepines and lamotrigine, for example, may blunt ketamine's effect; some blood-pressure and stimulant medications need extra attention. We review your full medication list at the evaluation, and because we manage your other psychiatric medications, we can adjust them if needed.

Some people notice improvement within hours to days of the first doses, much faster than conventional antidepressants. Others need several sessions. Benefit from a single dose typically fades over one to two weeks, which is why a course of repeated sessions is used, and why we pair it with ongoing care rather than treating it as a one-time fix.

There is growing evidence that ketamine reduces anxiety, especially anxiety that travels with depression. It is an off-label use with less research behind it than depression. We consider it case by case.

Early trials are encouraging but mixed, and PTSD use is off-label. Where ketamine may help most is in loosening the grip of symptoms enough that trauma therapy, including EMDR, which our practice offers, can do its work. We'll tell you where the evidence stands before you decide.

Not everyone responds. If a fair trial of troches doesn't help, we'll talk about next steps, which may include IV ketamine or Spravato elsewhere, medication changes, pharmacogenetic testing or therapy. You remain our patient either way.

Federal telehealth rules for prescribing controlled substances change periodically. Depending on the rules in effect when you enroll, your first evaluation may need to be in person at our Ann Arbor or East Lansing office. Follow-ups are usually by video. We'll tell you the current requirement when you call.

Yes, by telehealth. Our physical offices are in Ann Arbor and East Lansing.

A licensed compounding pharmacy that ships within Michigan. You pay the pharmacy directly, typically under $80 a month. See cost and insurance.

It varies. Many people do a more intensive phase of several weeks, then taper to occasional maintenance doses or stop. Appointment frequency follows the same pattern: closer together at first, then about every three months once stable.

Usually not. Ketamine is typically added to, not swapped for, your existing treatment. Since we manage those medications too, any changes are made in one place.