Best Rehabs with Ketamine Therapy in Washington

More About Ketamine Therapy

Ketamine is a dissociative anesthetic substance that is approved in the United States for medicinal use, primarily for sedation purposes.¹ Unfortunately, ketamine is also a highly misused substance, often sought after for the hallucinatory and delusional effects it produces.¹

However, this type of ketamine is not exactly the same type of ketamine that is used in ketamine-assisted therapy, which helps address challenges associated with treatment-resistant depression, or TRD. The ketamine used for therapeutic purposes is known as esketamine, which is a derivative of ketamine that is more tightly controlled and beholden to far stricter FDA standards than traditional ketamine.

What Is Ketamine Therapy?

Ketamine therapy is most established as a treatment for treatment-resistant depression (TRD), a persistent form of major depressive disorder that hasn't improved after trying other antidepressant medications. Ketamine therapy can work much faster than traditional antidepressants, and research shows intravenous ketamine can produce antidepressant effects within hours, with relief often lasting three to seven days per dose.²

Ketamine works differently than most antidepressants. Traditional antidepressants raise levels of serotonin, a chemical messenger linked to mood, and typically take weeks to have an effect.³ Ketamine instead targets glutamate, the brain's most abundant excitatory neurotransmitter, by blocking a receptor called NMDA to promote neuroplasticity, which is integral to how quickly results can be experienced.³

Evidence-Based Treatment

Ketamine's evidence base is strongest for treatment-resistant depression (TRD). A 2021 Cochrane systematic review found ketamine outperformed placebo in reducing depression symptoms, including suicidal thoughts, and increasing response rates, though the certainty of evidence varied across the studies included.⁴

Randomized controlled trials have also shown that ketamine infusion therapy can rapidly reduce chronic post traumatic stress disorder (PTSD) symptom severity, including a repeated-dose trial in which most participants responded after a two-week course.^5,6

Who Ketamine Therapy May Help

While esketamine has been approved for treatment of treatment-resistant depression, it is commonly used off-label to treat additional mood disorders, mental health conditions, and substance use disorders. Ketamine therapy may be helpful for:

• People with treatment-resistant depression who haven't responded to standard antidepressants.⁴
• People with chronic PTSD, as supported by randomized controlled trials showing reduced symptom severity after ketamine infusions.^5,6
• People with anxiety disorders, often alongside additional forms of psychotherapy.⁷
• People with a co-occurring mental health and substance use disorder, although the effectiveness of its use is still emerging. A small retrospective review of ketamine-assisted psychotherapy in patients with problematic substance use found reductions in anxiety and depression symptoms.⁸

Ketamine therapy isn't the right treatment approach for everyone. For example, people with a history of psychosis, uncontrolled high blood pressure, or unstable, active substance misuse typically need a different approach and a full clinical screening to determine what fits best.^7,9

What to Expect

The idea of using ketamine for therapeutic purposes is still fairly new to most people, and there is still so much the general public can learn. If you or someone you love is considering ketamine therapy, it can be helpful to be aware of what to expect prior to starting.

1. Assessment and evaluation: A thorough assessment and overall evaluation of your physical and psychological wellbeing is conducted prior to beginning any ketamine therapy sessions. This allows clinical professionals to determine if this type of therapy is a good fit for you or if you might benefit from a different approach.
2. Sessions: Sessions, which generally last anywhere from 40 to 90 minutes, are offered in a monitored clinical setting, or a structured at-home program with clinical oversight. The amount of sessions you receive depends on your own personal needs, however a standard course of care can include 6 to 8 sessions spread out over two weeks to a month, followed by maintenance sessions as needed.
3. Talk therapy: Many programs pair ketamine sessions with talk therapy before and after, sometimes called ketamine-assisted psychotherapy, to help process what comes up during sessions.

The initial course generally takes a few weeks from start to finish, and some people continue periodic maintenance sessions afterward.

Related Treatment Approaches

• Transcranial Magnetic Stimulation (TMS): A non-drug option that uses magnetic pulses to treat depression, sometimes considered alongside or after ketamine therapy for treatment-resistant cases.
• Eye Movement Desensitization and Reprocessing (EMDR): A trauma-focused therapy some providers use during the integration period following ketamine sessions.
• Cognitive Behavioral Therapy (CBT): A structured talk therapy frequently paired with ketamine dosing sessions to help patients process and apply what comes up.
• Somatic Experiencing: A body-based approach some providers use to support integration after a ketamine session.

Cost and Insurance

The cost of ketamine therapy varies depending on how ketamine is administered (e.g., IV infusion, intramuscular infusion, intranasal spray) as well as how many sessions a full course requires. Since esketamine carries FDA approval specifically for treatment-resistant depression, insurance companies can offer coverage for this purpose, however that coverage can vary.

Because coverage varies based on these factors and more (such as the details of your specific plan), it's worth confirming your specific benefits before starting treatment by contacting your insurance provider directly.

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Sources

1. Drug Enforcement Administration. (2020, April). Drug Fact Sheet: Ketamine.
2. Sakopoulos, S., Todman, M. (2025, July 11). The Effects of Psychotherapy on Single and Repeated Infusion(s) Therapy for Treatment-Resistant Depression: The Convergence of Molecular and Psychological Treatment.
3. DeWilde, K.E., Iosifescu, D.V., Levitch, C.F., Mathew, S.J., Murrough, J.W. (2015, February 3). The promise of ketamine for treatment-resistant depression: current evidence and future directions.
4. Dean, R. L., Hurducas, C., Hawton, K., Spyridi, S., Cowen, P. J., Hollingsworth, S., Marquardt, T., Barnes, A., Smith, R., McShane, R., Turner, E. H., & Cipriani, A. (2021). Ketamine and other glutamate receptor modulators for depression in adults with unipolar major depressive disorder. Cochrane Database of Systematic Reviews, 2021(9), CD011612.
5. Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., Kirkwood, K., Aan Het Rot, M., Lapidus, K. A., Wan, L. B., Iosifescu, D., & Charney, D. S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry, 71(6), 681-688.
6. Feder, A., Costi, S., Rutter, S. B., et al. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193-202.
7. Yavi, M., Lee, H., Henter, I. D., Park, L. T., & Zarate, C. A. (2022). Ketamine treatment for depression: a review. Discover Mental Health, 2, 9.
8. Whinkin, E., Eparwa, T. R. J., Julseth, M. C., Schneider, A., & Aggarwal, S. K. (2023). Reductions in anxiety and depression symptoms in a subset of outpatients with problematic substance use who received ketamine-assisted psychotherapy: a two-year retrospective chart review. Frontiers in Psychiatry, 14, 1160442.
9. Yip, R., Swainson, J., Khullar, A., McIntyre, R. S., & Skoblenick, K. (2022). Intravenous ketamine for depression: A clinical discussion reconsidering best practices in acute hypertension management. Frontiers in Psychiatry, 13, 1017504.