The Full FAQ

The first step is to call Nashville Ketamine Center at 615-601-1315 or request a consultation through the website. We will answer your initial questions, discuss whether a consultation is the appropriate next step, and help you understand what to expect.

For many patients, yes. If ketamine treatment appears appropriate after your psychiatric evaluation and you choose to move forward, treatment can often begin on the same day as your consultation.

Please make sure to bring your completed intake paperwork and any questions you want to discuss. If you have prior treatment records that are easy to access, they may be helpful, but they are not required for every patient.

If you previously received ketamine treatment at a different clinic or in a different state, please bring the dosage of the last treatment you received.

Yes. We understand that beginning ketamine treatment can feel like a significant decision. You are welcome to call with questions before scheduling.

You arrive, check in, and settle into a private room. Ketamine is typically given as an intramuscular injection. The effects begin within minutes and generally last about 40 to 60 minutes.

You are monitored throughout treatment and recover in the office before leaving with a responsible driver or approved rideshare transportation.

Ketamine affects each person somewhat differently. Most patients remain awake and recognize that they are in the treatment room, but their usual sense of time, space, and physical identity may become less fixed. Some people experience vivid imagery, memories, symbolic material, or the feeling of traveling through an internal landscape. Others experience a quieter sense of distance from their usual thoughts and concerns.

I sometimes describe the ketamine experience as creating space between the person and the patterns in which they have become stuck. Sometimes, our thoughts and emotions feel rigid, repetitive, and unquestionably true. During ketamine treatment, those familiar patterns may temporarily loosen, allowing a person to view themselves, their relationships, or their circumstances from a different perspective.

Not every treatment produces a profound journey, and a dramatic experience is not required for ketamine to be effective. However, when meaningful material does arise, it can sometimes become valuable material to reflect upon afterward or explore with a therapist.

There is no “right” way to experience ketamine treatment. Every person’s experience is unique. Our role is to monitor you and provide a safe, supportive environment while allowing the experience to unfold naturally.

Most patients remain aware of where they are, understand that they are receiving ketamine, and can communicate if they need something.

Ketamine may make you less interested in talking or less able to organize your thoughts in the usual way, but it does not typically cause people to behave unpredictably or reveal things against their will.

You will be monitored throughout treatment, and someone will be nearby if you need reassurance or assistance.

I often tell patients that they do not need to do anything except allow the experience to happen.

Most people rest with their eyes closed and listen to music. You do not need to talk, solve a problem, or direct your thoughts toward anything in particular. Trying too hard to control the experience usually makes it more difficult. There is no need to search for a breakthrough or decide whether the treatment is “working” while it is happening. I usually encourage patients to approach the experience with openness rather than expectation.

Some experiences feel meaningful, while others are quieter. Both are completely acceptable.

Your only task is to remain as comfortable and open as possible while we monitor you and support you throughout the session.

Avoid food for about four hours before treatment. Clear liquids are typically allowed up to two hours beforehand. Plan for approximately 75 to 90 minutes of in-office time.

You should also plan to avoid driving or making major decisions until the following day.

Yes. You cannot drive after treatment and should arrange transportation in advance.

It is acceptable to take an Uber or Lyft to or from an appointment. We will not allow you to leave in a rideshare until we believe you have recovered sufficiently to do so safely.

Most patients prefer to take the rest of the day off. You will usually feel fully back to baseline within a few hours, but the time needed for mental recalibration varies.

We usually recommend taking the day off from work and other responsibilities after your first treatment. After that first experience, you will have a better idea of how you respond to the medication and how to plan the remainder of the day.

Clinical studies and real-world experience suggest that approximately 70% to 80% of patients experience meaningful improvement, although no treatment works for everyone. Some people notice improvement rapidly, while others experience more gradual change over the course of an initial series of treatments.

Throughout treatment, we’ll continually assess how you’re responding and discuss whether continuing treatment makes sense. Our goal is always to help you make thoughtful, individualized decisions about your care.

One of the unique aspects of ketamine is that some people begin noticing improvement within hours or days rather than the several weeks often associated with traditional antidepressants.

For many patients, however, the most meaningful improvement develops gradually over the course of an initial series of treatments rather than after a single treatment.

There is no single pattern of response, and each person’s experience is different.

I get asked this question frequently, and after nearly a decade and a half of treating people with ketamine, I can comfortably say, “I don’t know for sure.”

Some patients experience relief that lasts only a couple of weeks, while many continue to feel better for months following their initial series of treatments. Some patients never need another treatment, while others benefit from occasional maintenance treatments over time.

The duration of improvement varies from person to person, so recommendations regarding maintenance treatment are always individualized and based on your response rather than a predetermined schedule.

Some patients experience lasting improvement following an initial series of treatments, while others benefit from periodic maintenance treatments over time.

There is no standard schedule. Recommendations are individualized and based on your symptoms, your response to treatment, and your goals for care. Together, we’ll determine what approach makes the most sense for your particular situation.

Spravato is the brand name for esketamine, a prescription nasal spray approved by the FDA for certain forms of depression. It contains one part of the ketamine molecule and is self-administered through the nose while the patient is being supervised.

Spravato can be a helpful treatment, particularly for patients whose insurance provides coverage or who need ongoing maintenance treatment.

At Nashville Ketamine Center, we primarily administer ketamine through an intramuscular, or IM, injection. IM and IV treatments use racemic ketamine, which contains both parts of the ketamine molecule. With IV treatment, ketamine is delivered gradually through a vein. With IM treatment, the medication is absorbed reliably through the muscle, the effects begin within several minutes, and the dose can be carefully individualized.

In my clinical experience, IM ketamine often produces a fuller and more robust treatment response.

At Nashville Ketamine Center, we primarily use intramuscular, or IM, ketamine because it is reliable, efficient, and allows treatment to be individualized.

IM ketamine is administered as an injection into the muscle. The medication is absorbed quickly, the effects usually begin within several minutes, and there is no need to place or maintain an IV line during treatment.

After many years of treating patients with ketamine, I have found IM treatment to be an effective and well-tolerated approach. It allows me to carefully select the dose, observe how each person responds, and make adjustments during future treatments when appropriate.

My preference for IM ketamine is based on clinical experience rather than the belief that there is only one correct way to administer ketamine. After approximately 15 years of providing ketamine treatment, I have found IM administration to be a reliable and highly effective alternative to IV treatment.

Patients also tend to be more comfortable receiving an IM injection rather than having an IV remain in their arm throughout treatment.

Spravato is a legitimate and potentially helpful treatment, but it operates through a highly structured treatment and insurance model that is different from the way our practice is designed.

At Nashville Ketamine Center, I have chosen to focus on IM ketamine because it allows me to individualize the dose, observe each patient’s response closely, and provide what I believe is often a more robust initial treatment experience.

It also allows treatment decisions to be based directly on the individual patient rather than on the requirements of a particular insurance authorization or medication protocol.

This does not mean that Spravato is a poor treatment or that it cannot be effective. For some people, particularly when insurance coverage makes it more accessible, it may be a very reasonable option.

My preference for IM ketamine reflects the treatment model I have developed through many years of clinical experience and the kind of care our clinic is structured to provide.

Ketamine-assisted psychotherapy, often abbreviated as KAP, combines ketamine treatment with psychotherapy.

Depending on the treatment model, a therapist may help the patient prepare beforehand, remain with the patient during part or all of the ketamine experience, meet afterward for integration, or provide some combination of these services.

KAP is not a particular route of administering ketamine. Ketamine-assisted psychotherapy can be offered with IM, IV, intranasal, or oral ketamine.

During a traditional IM or IV ketamine treatment, the medication experience itself is the primary focus. Patients generally rest, listen to music, and allow the experience to unfold without trying to have a conventional therapy conversation during the session. Any thoughts, emotions, memories, or perspectives that emerge can then be explored afterward.

KAP can be arranged at Nashville Ketamine Center through a therapist who works collaboratively with our clinic and can be present for treatment when that approach appears appropriate.

However, many patients do not need to change therapists or begin a separate course of ketamine-assisted psychotherapy. If you already have a therapist you know and trust, I will often recommend continuing that relationship while receiving IM ketamine treatment with us.

Ketamine experiences sometimes bring forward memories, feelings, images, relationships, or new ways of understanding a problem. I often suggest that patients take this material back to their regular therapist, much as someone might bring an important dream into therapy. The patient and therapist can then explore what emerged, understand what it may mean, and determine how it relates to the patient’s life.

I believe this approach often provides adequate therapeutic support for an individual’s ketamine treatment process. Your established therapist already understands your history, relationships, defenses, strengths, and ongoing goals. Rather than introducing a second therapist for a small number of ketamine sessions, the experience can become useful material within the therapeutic relationship you have already developed.

For patients who do not have an established therapist, or who specifically want a therapist present as part of ketamine treatment, we can discuss whether our collaborating KAP provider would be appropriate.

Yes. In most cases, I encourage patients to continue working with their regular psychiatrist, therapist, or other mental health providers during the days and weeks they receive ketamine treatment.

Ketamine is not intended to replace the clinicians who already know you and understand your history. Instead, it can become another part of your overall treatment plan.

Your regular psychiatrist can continue managing your medications and broader psychiatric care. Your therapist can help you understand and work with any thoughts, emotions, memories, or new perspectives that emerge during treatment.

Ketamine sometimes creates a temporary distance from familiar patterns of thinking. A person may notice something differently, remember an experience, recognize a relationship pattern, or see a longstanding problem from a new perspective.

I often encourage patients to take that material back to their therapist, much as someone might bring an important dream into therapy and explore what it means.

We are also happy to collaborate with your existing providers when appropriate. The goal is not to disrupt care that is already helping you, but to make ketamine treatment a useful and well-integrated part of your overall care.

The initial appointment, which includes the psychiatric consultation and first ketamine treatment when treatment is appropriate, is $600. Each subsequent ketamine treatment is $550.

Most patients begin with a series of six treatments over approximately two weeks, although recommendations are individualized based on your history, response, and goals.

We will review the recommended treatment plan and expected cost before you begin, so you are not trying to make that decision without clear information.

Nashville Ketamine Center is a self-pay practice for ketamine treatment and does not bill insurance directly. Ketamine treatment for depression and related conditions is often not covered by insurance, and coverage varies widely by plan.

If your insurance plan allows out-of-network reimbursement, we can provide documentation that you may submit to your insurer. Reimbursement is not guaranteed.

The consultation includes a psychiatric evaluation with Dr. Barton focused on whether ketamine treatment is a safe and appropriate option for your particular situation.

We will review your symptoms, treatment history, relevant medical and medication history, goals for care, and practical questions about treatment.

For many patients, if ketamine appears appropriate and you choose to move forward, the first treatment can often begin on the same day.

We will be straightforward about the expected cost of care before treatment begins. Because recommendations are individualized, the best starting point is to understand whether ketamine is appropriate and what treatment plan makes sense clinically.

If cost is a concern, please tell us. We would rather discuss it openly than have you feel uncertain or pressured.

When ketamine is administered in an appropriate medical setting and patients are carefully screened and monitored, it has an excellent safety record. In fact, ketamine has been used safely in medicine for more than 50 years.

Like any medical treatment, ketamine is not appropriate for everyone. During your psychiatric evaluation, we’ll review your medical and psychiatric history to determine whether ketamine is a safe and appropriate treatment option for your particular situation.

Throughout each treatment, you’ll be monitored by experienced medical staff, and your safety and comfort remain our highest priorities.

Ketamine itself is FDA-approved as an anesthetic medication. Its use for depression, PTSD, and other psychiatric conditions is considered off-label.

Off-label prescribing is common in medicine and means that a physician is using an approved medication for a condition, dose, or method of administration that is not specifically listed in the original FDA approval.

Spravato, which contains esketamine and is administered as a nasal spray, is FDA-approved for certain forms of depression.

IM and IV racemic ketamine are not specifically FDA-approved for depression, even though they have been studied extensively and have been used in psychiatric treatment for many years.

The fact that a treatment is used off-label does not mean that it is experimental, inappropriate, or unsafe.

When ketamine is used in a carefully monitored medical setting for the treatment of depression and other mental health conditions, there is very little risk of developing an addiction to ketamine.

Ketamine can be misused outside of medical settings, which is one of the reasons treatment should always occur under appropriate medical supervision. Our goal is to use ketamine thoughtfully, safely, and only when it is medically appropriate.

Most side effects are temporary and resolve within an hour or two. These may include mild dissociation, dizziness, nausea, headache, or brief increases in blood pressure.

Serious adverse effects are uncommon in appropriately screened patients.

Most patients are able to continue taking their current medications during ketamine treatment. However, some medications may affect ketamine’s effectiveness or require special consideration.

The class of medications called benzodiazepines, including Xanax and Klonopin, can sometimes decrease the effectiveness of ketamine or prevent it from fully working. There are circumstances in which it does not make sense to decrease the dose or stop these medications. This should be discussed with our clinic but managed by your primary prescriber.

During your consultation, Dr. Barton will carefully review your current medications and discuss whether you should consider any possible adjustments with your primary prescriber.

You should never stop or change a prescribed medication without first discussing it with the clinician who prescribes it.

Ketamine is most commonly used for treatment-resistant depression and major depressive disorder.

It may also be considered for bipolar depression during the depressive phase, complex PTSD, PTSD symptoms linked to mood dysregulation, anxiety when it is driven by depressive patterns, and suicidal thinking as an acute symptom rather than a standalone diagnosis.

Ketamine is not appropriate for primary psychotic disorders such as schizophrenia.

No. Ketamine is often considered when traditional treatments have not provided adequate relief.

Some patients come after years of unsuccessful medication trials or psychotherapy. Others come earlier because they are looking for a treatment that works differently, may act more quickly, or has a different side-effect profile than many traditional medications.

Whether ketamine is appropriate depends on your individual situation.

Yes. In fact, ketamine can be an excellent treatment option for individuals experiencing the depressive phase of bipolar disorder.

One reason psychiatrists have become interested in ketamine for bipolar depression is that the risk of triggering mania appears to be relatively low. However, that risk is not zero, and careful evaluation and monitoring remain important.

During your consultation, Dr. Barton will review your history and current symptoms to determine whether ketamine is an appropriate option for your particular situation.

Research suggests that ketamine may be helpful for many individuals experiencing post-traumatic stress disorder, or PTSD, and we have treated many patients whose trauma-related symptoms have improved with ketamine therapy.

PTSD is often more than the memory of a traumatic event. It can affect mood, anxiety, sleep, emotional regulation, and the ability to feel safe in everyday life.

Whether ketamine is appropriate depends on your individual history, symptoms, and treatment goals.

Although ketamine is best known for treating depression, many patients also experience meaningful improvement in anxiety symptoms. This is especially true to the degree that an individual’s anxiety is related to, or caused by, depression or a trauma-related condition.

Because anxiety can arise from many different causes, the degree of improvement varies from person to person. During your evaluation, we’ll discuss your symptoms and whether ketamine appears to be an appropriate treatment option.

Although ketamine can be remarkably helpful for many people, it is not appropriate for everyone.

Certain medical conditions, uncontrolled hypertension, active psychosis, some substance-use disorders, pregnancy, or other medical or psychiatric factors may make ketamine treatment inappropriate or require additional evaluation before proceeding.

Determining whether ketamine is appropriate begins with a careful psychiatric evaluation and discussion of your medical history, current symptoms, and treatment goals.