How to Ask Your Doctor About Ketamine Therapy
How to ask your doctor about ketamine therapy: what history to bring, the questions worth asking, and how to handle a skeptical response.
Ketamine Uplift Education
Patient Care Team
Cost & Getting Started
Short answer: Book a dedicated appointment, bring a clear record of the treatments you have tried and for how long, and ask directly whether your depression counts as treatment-resistant and whether ketamine or Spravato fits. Frame it as a question about your care plan, not a request for a prescription, and ask how you would coordinate care if you move forward.
Why the conversation is worth having
Esketamine (Spravato) has been FDA-approved for treatment-resistant depression since 2019, and in January 2025 the FDA cleared it for use on its own, without a daily oral antidepressant. IV ketamine for depression remains off-label but has a substantial body of peer-reviewed research behind it.
Ketamine is also a controlled medication with real side effects, including dissociation, temporary blood pressure rises, and nausea, and long-term data is still limited. Your current clinicians know your history and risk factors, which makes them a genuine safety asset.
What to bring
A one-page written summary makes a short visit far more productive:
Every antidepressant or mood medication you have tried, with approximate dose, how long you took it, and why you stopped.
Therapy history, including type and rough duration.
Other treatments, such as TMS, ECT, or add-on medications.
Current medications and supplements, since some can interact with ketamine.
Key health history, especially blood pressure, heart conditions, substance use, or psychosis.
Duration matters. Ten days on a medication and three months on it tell very different stories.
The questions worth asking
Would you consider my depression treatment-resistant? A common working definition is no adequate response to at least two antidepressants at a proper dose and duration, and our guide to treatment-resistant depression explains why that definition varies.
Is ketamine or Spravato appropriate for me, and does anything in my history concern you?
Which route makes more sense for me? The two differ in delivery, monitoring, and payment, and our comparison of ketamine vs. Spravato covers the details.
Should I keep my current medications? Never stop or change one on your own.
If I move forward, how would we coordinate care?
If your doctor is skeptical
Some clinicians are cautious, and some have not followed the research. Ask what specifically concerns them. Often it is concrete: blood pressure, a substance use history, or uncertainty about long-term durability. Those are exactly the issues a careful ketamine provider screens for too.
If you still feel unheard, a second opinion from another psychiatrist is a normal part of medicine.
Keeping your care team involved
Ketamine works best as part of a plan, not a replacement for one. Your psychiatrist or primary care doctor can keep managing your medications, and your therapist can help you build on any progress. Talking with the people at home is its own conversation, and our guide to talking with family about ketamine therapy covers that side.
At Ketamine Uplift, we generally encourage patients to keep their existing clinicians in the loop. With your written permission, we can typically share treatment information with outside providers and stay in touch about your progress. Ask us how that would work in your case.
How getting started works here
You do not need a referral to start. A care navigator begins with a short discovery call about the process and costs, then schedules a complimentary telehealth evaluation with Dr. Geoffery O'Neill, a board-certified anesthesiologist, who reviews safety first and then decides whether treatment is appropriate. Our walkthrough of how to qualify for ketamine treatment lays out each step. We offer IV ketamine as our core program as well as Spravato, and since Spravato coverage varies by plan, we can help you check your benefits.
This article is for educational purposes only and is not medical advice. Ketamine is a controlled medication administered under medical supervision. Consult a licensed provider about your individual situation.
The bottom line
Asking your doctor about ketamine is easier with your treatment history in hand and a few focused questions. Skepticism is usually a starting point, and keeping your clinicians involved makes any next step safer. To talk it through with us first, call (310) 280-4440.
Frequently asked questions
Do I need a referral for ketamine therapy? Not always. Many clinics, including ours, start with their own evaluation, though your doctor's input remains valuable and we can coordinate with them with your permission.
What if my doctor says no? Ask what specifically concerns them, since many concerns are medical and worth taking seriously. A second opinion from another psychiatrist or a ketamine provider's evaluation is a reasonable next step.
Can my psychiatrist give me Spravato? Spravato can only be administered in healthcare settings certified under the FDA's Spravato REMS program, with at least two hours of monitoring afterward. Your psychiatrist can refer you to a certified site.
Should I stop my antidepressant before ketamine? Do not stop or change any medication on your own. Any adjustment should be decided by your prescriber together with the ketamine provider.
Ketamine Uplift Education
Patient Care Team
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