Ketamine
An anesthetic used in hospitals for more than 50 years, and the only psychedelic-like medicine a doctor can prescribe for depression today. It can lift symptoms within hours, which makes it different from antidepressants that take weeks.
Last reviewed: November 2, 2026
The basics
Ketamine works mainly on glutamate, the brain's main "go" signal, rather than on serotonin like most antidepressants. At low doses it can cause a dreamlike, detached state for about an hour. People receive it two main ways: Spravato (esketamine), an FDA-approved nasal spray given in certified clinics, and IV ketamine infusions, which doctors offer off-label. Benefits often fade without repeat sessions, so most treatment plans include a series of doses.
| Where | Status |
|---|---|
| United States, federal | Schedule III. Approved as an anesthetic. Spravato is FDA-approved for treatment resistant depression. |
| Spravato (esketamine) | Given only in certified clinics, with two hours of monitoring after each dose. Approved on its own or with an antidepressant. |
| IV and at-home ketamine | Prescribed off-label. Telehealth prescribing rules are extended through December 31, 2026. |
Foundational studies
What's happening now
Capped at five. Oldest rotates to the archive at each review.
From the show
The Reality of Ketamine Therapy
What ketamine therapy is really like, from people who have been there.
Watch on YouTube →Two Psychonauts, No Filter | DMT, 5-MeO-DMT, Ketamine & Beyond
Two experienced psychonauts, decades of exploration, and one candid conversation. Dr. DREAM and Tom share their personal journeys with 5-MeO-DMT, N,N-DMT, ketamine, ibogaine, psilocybin, salvia and more.
Watch on YouTube →This page is for education only and is not medical advice. Ketamine is a Schedule III controlled substance and should only be used under a licensed medical provider's care. Talk with a qualified professional before making any health decision.