Frequently Asked Questions About
IV Ketamine Therapy & Spravato®

Most of our patients come to us through their mental health providers, but a referral is not required to begin care. We work with individuals who are already established with a therapist or psychiatric provider, as well as those who are not currently in treatment. For patients without an existing care team, we can help guide next steps and coordinate support as needed. If you do have a provider, we encourage collaboration — our clinicians are happy to connect directly with your care team to ensure a thoughtful, coordinated approach.

Clinical studies of IV ketamine often focus on people with Treatment-Resistant Depression (TRD), meaning they have not responded to at least two rounds of traditional antidepressants. Spravato® (esketamine) is specifically FDA-approved for adults who have not responded to at least two antidepressants, making prior medication trials a formal requirement for that treatment path. For IV ketamine, many providers recommend starting with antidepressants first, however patients who prefer not to pursue antidepressants — due to limited effectiveness, delayed onset, or side effects — may still be eligible as an initial treatment option. We recommend discussing your history and preferences with your mental health provider, and our clinical team can provide guidance about whether IV ketamine or Spravato® is the most appropriate path forward.

We provide care for patients across a wide age range, from adolescents to older adults. For patients between ages 14–18, we require that they also be working with an adolescent psychiatrist, and we coordinate closely with parents or caregivers to ensure safe, supportive treatment.

Most commonly prescribed medications are safe to continue while receiving IV ketamine therapy or Spravato® (esketamine). Both treatments have a strong safety profile and few side effects, and patients are typically able to remain on their oral antidepressants — in fact Spravato® is specifically designed to be used alongside an oral antidepressant. However, certain medications — such as benzodiazepines, GABA-like substances, lamotrigine, and naltrexone — may reduce ketamine’s antidepressant response. Your prescribing clinician will work with you to review your medications and determine the best plan for your care.

Yes. Ketamine can be a safe and effective option for patients with depression who also have a history of trauma or PTSD. Some sessions may bring up challenging memories or emotions, but patients often describe experiencing them from a new or more neutral perspective. This shift can make it easier to process those experiences with a therapist afterward. Many patients find that even difficult sessions become some of the most meaningful, helping them move forward in their healing journey.

Ketamine can be misused in non-medical settings, but when administered under medical supervision at Better Health Whole Wellness Center in Rittenhouse Square, Philadelphia — whether as IV ketamine therapy or Spravato® (esketamine) nasal spray — the risk of addiction is extremely low. Treatment protocols are carefully designed, infrequent, and closely monitored by trained professionals. Patients do not develop physical dependency, and stopping treatment does not cause withdrawal symptoms.

Certain medical conditions may affect eligibility for IV ketamine therapy or Spravato® — including uncontrolled hypertension, a personal or family history of psychosis, or certain cardiovascular conditions. If you have concerns about your health history, we encourage you to speak directly with our care team. We will review your medical background carefully to ensure treatment is safe and appropriate for you.

Many patients begin noticing meaningful changes within hours to days of their first session — particularly with Spravato®, which is known for its rapid onset. IV ketamine also acts faster than traditional antidepressants, with many patients reporting shifts in mood and perspective during or shortly after their initial infusions. Individual responses vary, and our team monitors your progress closely through standardized mood assessments every two weeks to track your response and adjust your care plan accordingly.

At Better Health Whole Wellness Center, we specialize in supporting patients living with Major Depressive Disorder (MDD) and the depressive phase of Bipolar Disorder. Depression is not a one‑size‑fits‑all experience. We often care for individuals who may also be navigating suicidal thoughts, trauma recovery, pregnancy and postpartum changes, adolescence, addiction, or aging‑related challenges. Our approach is personalized, recognizing the complexity of each person’s journey.

Relief looks different for everyone. For some, it’s the quieting of intrusive thoughts; for others, it feels like a heavy weight lifted or mental fog cleared. Patients often describe renewed energy to tackle everyday tasks, the ability to say “yes” to life again, or the return of emotional balance. At Better Health Whole Wellness Center, we measure relief using evidence‑based tools like the PHQ‑9 mood survey, comparing scores before and after treatment to track meaningful progress.

Yes. Ketamine has been safely used in hospitals and clinics worldwide for decades, particularly in anesthesia and emergency medicine. Spravato® (esketamine) is FDA-approved and administered under a formal Risk Evaluation and Mitigation Strategy (REMS) program, which requires on-site administration and monitoring at every session. At Better Health Whole Wellness Center, both IV ketamine infusions and Spravato® sessions are administered by trained medical professionals in a monitored setting to ensure the highest standards of safety.

Both IV ketamine and Spravato® (esketamine) can cause temporary side effects such as nausea, dizziness, increased heart rate, or mild dissociation during treatment. These effects typically resolve quickly, and our team closely monitors every patient throughout the process. For Spravato® patients, blood pressure is monitored at specific intervals during the required two-hour post-session monitoring period. When used at appropriate doses for depression, neither treatment has known long-term negative effects. Risks are primarily associated with misuse or daily recreational use — very different from the medically supervised care we provide.

“KAP” refers to combining ketamine with psychotherapy to help patients find relief from mental health symptoms. At Better Health Whole Wellness Center, our protocols are designed specifically for depression, reflecting the fact that most clinical research on ketamine has centered on this condition. We administer ketamine intravenously (IV) — which studies show achieves meaningful response in up to 75% of patients with treatment-resistant depression in some trials — or as Spravato® (esketamine) nasal spray, which is FDA-approved and has shown response rates approaching 70% in clinical studies. Unlike some practices that conduct therapy during the altered state, we encourage structured therapy sessions before and after treatment sessions, when evidence shows the greatest therapeutic benefit. This model reflects our commitment to gold-standard, evidence-based care.

IV ketamine is an FDA-approved generic drug used on-label as an anesthetic and recognized as one of the World Health Organization’s essential medicines. For depression, IV ketamine is used off-label at sub-anesthetic doses — a common and well-established practice in psychiatry, where approximately 60% of medications are prescribed off-label. Spravato® (esketamine) nasal spray is different — it carries full FDA approval specifically for treatment-resistant depression and major depressive disorder with suicidal ideation, making it the only ketamine-based treatment with on-label FDA approval for depression. At Better Health Whole Wellness Center, we offer both options in a medically monitored environment with one-on-one patient care and strict adherence to safety standards.

Currently, most insurers do not cover IV ketamine for depression in-network. However, many patients receive out-of-network reimbursement — though reimbursement rates vary by plan and provider, and individual results may differ. Because insurance navigation can be confusing, we provide clear guidance and resources to help patients submit claims and work toward maximizing their coverage.

Spravato® (esketamine) nasal spray is different — it IS covered by most major insurance plans when administered in a certified clinical setting like Better Health Whole Wellness Center. If cost is a concern, Spravato® may be a more accessible option and our team can help determine your eligibility. For specific questions about your plan, we recommend contacting your insurance provider directly or reaching out to us — we’re happy to help guide you through the process.

Both IV ketamine and Spravato® (esketamine) target similar brain pathways and are used to treat depression, but they differ in important ways. IV ketamine is administered intravenously and is supported by the most extensive body of clinical research — offering the strongest evidence for effectiveness, precise dosage control, and the ability to pause or adjust treatment in real time. Spravato® is a nasal spray that is FDA-approved on-label for treatment-resistant depression and covered by most major insurance plans, making it a financially accessible and clinically validated alternative. Some patients pursue both treatments at different stages of their care. Our clinical team will work with you to determine which approach — or combination — best fits your diagnosis, history, insurance coverage, and treatment goals.

In most cases yes — both IV ketamine and Spravato® (esketamine) are designed to work alongside existing medications. Spravato® is specifically FDA-approved for use in combination with an oral antidepressant. However, certain medications such as benzodiazepines, lamotrigine, and naltrexone may reduce ketamine’s antidepressant response. Your prescribing clinician will review your current medications carefully before treatment begins to ensure the safest and most effective care plan for your individual situation.

Schedule a free 15 minute call with our clinical psychologist, Dr. Liggera, to determine if you’re qualified. Email info@bhwwc.com to schedule.

Absolutely. We often hear from parents, partners, and family members who want to explore options for someone they care about. We’re happy to speak with you, but we’ll also need to connect directly with the individual before moving forward with treatment.

At Better Health Whole Wellness Center, we collaborate closely with licensed mental health providers such as psychiatrists, psychologists, therapists, or primary care doctors. If you don’t currently have a provider, we can connect you to trusted professionals in our network to ensure you have the right support team in place before beginning care.

First, you will schedule a physical exam with one of our providers that is covered by insurance, and if you have a referral from your psychiatrist, we will immediately schedule you for your treatment. If you don’t have a psychiatrist/psychologist, we will schedule you with out psychiatric nurse practitioner, which is also covered by insurance. After that visit, we will schedule you for either IV Ketamine or Spravato® depending on what is recommended.

Relief can begin within hours of the first session — this rapid onset is one of the most meaningful advantages of both IV ketamine therapy and Spravato® (esketamine) compared to traditional antidepressants. For IV ketamine patients, many notice the most significant improvements over the course of a two-week foundational series of six infusions. For Spravato® patients, the FDA-approved protocol begins with twice-weekly sessions and most people report noticeable reduction in depressive symptoms within the first few weeks. Individual results vary and our team monitors your progress closely through standardized mood assessments every two weeks.

Yes. New patients can receive a complimentary 15-minute virtual consultation with our Licensed Clinical Psychologist to determine if ketamine therapy is right for them. We also provide telehealth appointments with our Licensed Clinical Psychologist or our Psychiatric Mental Health Nurse Practitioner. Most commercial insurance plans cover these services. 

Both IV ketamine and Spravato® stimulate neural growth and promote neuroplasticity, but stress and trauma can gradually diminish those gains over time. To maintain improvements, patients often return for booster infusions or Spravato® sessions at regular intervals. These follow-up treatments help sustain mood stability and extend the benefits of the initial treatment series.

For IV ketamine patients, most return for a booster infusion every 4–8 weeks, though timing varies by individual. For Spravato® patients, after the initial twice-weekly series the protocol typically moves to weekly and then every-one-to-two-weeks sessions as determined by your clinical response. Some patients feel relief for months between sessions, while others notice symptoms returning sooner. Engaging in therapy, building wellness routines, and practicing healthy habits can help extend the time between visits for both treatment paths.

We track your progress through regular PHQ-9 mood assessments and collaborate with you and your care team to determine the right timing for follow-up care — whether that means a booster IV ketamine infusion or a Spravato® session. Our goal is to provide personalized, sustainable treatment rather than a one-size-fits-all schedule. This approach makes care more affordable, accessible, and effective over the long term.

Our doctors connect directly with your provider team to review your medical history and establish a collaborative plan. We maintain communication through calls, emails, and secure updates, and we share regular progress reports based on your mood surveys and treatment cadence.

Yes — Spravato® (esketamine) is covered by most major insurance plans when administered in a certified clinical setting like Better Health Whole Wellness Center. This means that for patients who qualify, ongoing Spravato® sessions may be significantly more affordable than out-of-pocket IV ketamine booster infusions. Our team can help you understand your coverage and determine whether Spravato® or IV ketamine — or a combination of both over time — makes the most sense for your long-term care plan and budget.

We believe that how patients prepare for ketamine therapy directly influences the benefits they receive. Before each IV ketamine infusion or Spravato® (esketamine) session, we guide patients in setting an intention — a personal commitment to a mindset or way of being, such as “be kinder to myself” or “let go of anger.” To reinforce these intentions, we offer supportive care rituals that engage the senses and encourage mindfulness. Patients may choose calming aromatherapy, curated music to accompany their session, or a hand-blended tea to close their appointment. These practices are not medical treatments themselves, but they help patients feel grounded, present, and empowered in their care journey.

Preparation plays a key role in maximizing the therapeutic potential of ketamine care. We encourage patients to approach each session with a calm, open mindset and clear goals for wellness. In the days leading up to treatment, consider the following:
Minimize stress and support your body: Avoid alcohol or recreational drugs, follow your care team’s guidance on medications, and engage in restorative activities such as deep breathing, light exercise, or time outdoors. Reflect on your goals: Infusions often bring profound insights — from connectedness and relationship reflections to personal growth themes. Setting an intention beforehand helps guide your experience. Manage expectations: Relief looks different for each person, and timelines vary. While many patients experience improvement, success is not guaranteed. Preparing emotionally for different outcomes can help you feel more balanced.

On the day of your infusion:
Plan safe transportation: You will not be able to drive for at least 12 hours after an IV ketamine infusion, or for the remainder of the day following a Spravato® session. Arrange a ride service, or a trusted companion to ensure you get home comfortably. Allow time for reflection: Many patients prefer to keep the rest of the day open for journaling, quiet time, or restorative activities. Consider arranging childcare or other responsibilities so you can focus on recovery. Engage your therapist: Scheduling a session with your therapist before and after treatment can help you prepare mentally and process insights afterward. Patients often find these conversations especially meaningful within the first few days following care.

Most patients receiving IV ketamine therapy or Spravato® (esketamine) at Better Health Whole Wellness Center describe their sessions as peaceful and introspective. The altered state experience varies between the two treatments — IV ketamine tends to produce a more immersive, pronounced internal experience, while Spravato® sessions are often described as milder in intensity. Many patients across both treatments feel as though they enter an “inner space,” often likened to being in therapy with themselves.

Patients often report common themes:

Perspective‑shifting: A sense of “zooming out,” seeing life and relationships from new angles.
Meditative: A quieting of the inner voice, with imagery like vast skies or open landscapes.
Connective: A deepened awareness of how all living things and relationships are interlinked.
Reflective: Gratitude for people, memories, or life events, sometimes revisiting past experiences.
Dream‑like: Fantastical or surreal settings, similar to the way dreams weave together recent thoughts.

Each experience is unique, and no single type has been shown to be medically superior. We share these themes to help patients and providers find language for what may unfold.

Yes — and this is one of the key advantages of IV ketamine. Because it’s delivered directly into the bloodstream, the infusion can be slowed or stopped at any time, allowing the patient to return to their normal state within just a few minutes. This level of control is one of the main reasons our team prioritizes IV administration over other delivery methods. For Spravato® (nasal spray), the medication cannot be reversed once administered. However, our clinical team remains present throughout the entire two-hour monitoring period and is trained to provide support, reassurance, and grounding techniques if a patient feels uncomfortable at any point. In practice, distress during either treatment is uncommon. Most patients find the experience manageable and often describe it as deeply therapeutic.

A licensed clinician is present throughout every IV ketamine infusion and Spravato® session. For Spravato® patients, FDA guidelines require that a healthcare provider be on-site for the full two-hour monitoring period following administration. For all patients, our team’s role is to ensure both medical and psychological safety — monitoring closely, intervening immediately if complications arise, and providing grounding techniques or reassurance if the experience feels challenging.

There is no “right” way to experience ketamine therapy. While some patients describe profound insights, others have quieter sessions. The antidepressant benefit of ketamine does not depend on the intensity of the altered state — relief can occur regardless of how the experience feels.

Ketamine can be misused in non-medical settings, but medically supervised IV ketamine infusions and Spravato® (esketamine) sessions at Better Health Whole Wellness Center in Rittenhouse Square, Philadelphia follow strict protocols to prevent misuse. Spravato® is additionally administered under an FDA Risk Evaluation and Mitigation Strategy (REMS) program, which requires on-site administration and monitoring at every session. When administered infrequently under professional supervision, neither treatment creates physical dependency, and patients do not experience withdrawal symptoms when treatment ends.

We strongly advise patients not to drive or operate heavy machinery for at least 12 hours after an IV ketamine infusion. For Spravato® patients, driving is not permitted on the day of treatment — FDA guidelines require patients to arrange transportation in advance for every Spravato® session without exception. Many patients feel comfortable arranging a ride with a friend, or a ride share service. Loved ones are welcome to wait in our office during treatment if they are providing transport. We also recommend giving yourself time to rest and reflect after your session before returning to daily responsibilities.