When antidepressants haven't worked, ketamine therapy offers a scientifically validated path to fast, meaningful relief — often within hours to days of the first session.
Ketamine is an FDA-approved anesthetic that has emerged as one of the most significant breakthroughs in psychiatric medicine in decades. Unlike traditional antidepressants that target serotonin or norepinephrine, ketamine works on the glutamate system — the brain's most abundant excitatory neurotransmitter — producing rapid antidepressant effects that can occur within hours rather than weeks.
Research shows ketamine is effective for approximately 70% of patients with treatment-resistant depression — meaning patients who have failed two or more adequate antidepressant trials. It is also used for severe anxiety, PTSD, and suicidal ideation in a supervised medical setting.
At Mental Health Associates San Antonio, we offer IV ketamine infusions, IM ketamine injections, and oral ketamine options, all administered in a comfortable, medically supervised environment.
Am I a Candidate? Let's Talk.We offer multiple delivery methods depending on your clinical needs, preferences, and insurance situation.
Intravenous infusion provides the most precise, controllable dosing and the strongest evidence base. Sessions typically last 40–60 minutes. Patients often report dissociative experiences during infusion, which resolve quickly afterward.
Intramuscular ketamine offers a slightly faster onset than IV and is administered via a simple injection. It's a good alternative for patients who prefer to avoid IV lines. Sessions are similarly supervised by our clinical team.
Oral (troché or liquid) ketamine has lower bioavailability but offers a gentler experience and may be appropriate for maintenance therapy between infusion series. Dosing is carefully calibrated to your response history.
Ketamine therapy is not a first-line treatment — it's designed for patients who have not found adequate relief through standard psychiatric care.
You may be a candidate for ketamine if you have been diagnosed with depression, anxiety, PTSD, or bipolar depression and have tried two or more antidepressants or mood stabilizers without achieving remission.
Ketamine may also be considered for patients experiencing active suicidal ideation who need rapid stabilization, or for individuals who cannot tolerate standard antidepressants due to side effects.
Ketamine is not appropriate for everyone. Your provider will carefully screen you for contraindications including:
All ketamine sessions are conducted under medical supervision with monitoring equipment on-site.
A standard induction series consists of 6 infusions over 2–3 weeks. Many patients experience significant improvement during or immediately after this series. Booster infusions may be recommended monthly or as needed to maintain results.
Yes. Ketamine infusions use sub-anesthetic doses — you will be awake but in a deeply relaxed, dissociative state. Many patients describe perceptual changes, vivid imagery, or a dreamlike quality. These effects fully resolve within 15–30 minutes of the infusion ending.
Coverage varies significantly. IV ketamine infusions are often not covered by insurance for psychiatric indications, though Spravato® (esketamine) is FDA-approved for treatment-resistant depression and may have better coverage. We review each patient's insurance on a case-by-case basis.
Spravato® is an FDA-approved nasal spray form of esketamine (S-ketamine), administered in our office with a required 2-hour observation period. IV and IM ketamine are off-label uses of the anesthetic form (racemic ketamine). We offer both. See our Spravato page for details.
Schedule a consultation with our psychiatric team to evaluate your candidacy and discuss your treatment goals.
Mental Health Associates San Antonio is a proud member of Privia Medical Group — a high-performance physician network committed to coordinated, patient-first care across San Antonio and beyond.