Tirzepatide + B12
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with vitamin B12 for energy.
Injection
from $208/mo
Dissolved under the tongue · Once a day
DepressionTreatment-resistantRapid relief
Ketamine ODT (Orally Disintegrating Tablet)
Ketamine: dissociative anesthetic repurposed for treatment-resistant depression and severe depressive episodes. Sublingual (under-tongue) tablet for rapid onset. Strong emerging evidence; close physician oversight required.
- Rapid onset of action: relief within hours to days, not weeks
- Effective for treatment-resistant depression when SSRIs fail
- Dissociation managed by physician; dose and setting controlled
- Monthly$249/mo
- Every 3 monthsBest value$657 billed up front$219/mo
- Free, discreet shipping
- Licensed U.S. pharmacy
- Board-certified physicians
Disclaimer: Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.
- How
- Dissolved under the tongue
- How often
- Once a day
- Each shipment
- 30 tablets
- Strengths
- 2 options · 50–100 mg
What is ketamine for depression?
(racemic ketamine, NMDA receptor antagonist)
Ketamine is an NMDA receptor antagonist originally used for anesthesia. At sub-anesthetic doses, it produces rapid antidepressant effects distinct from SSRIs or MAOIs. The mechanism is not fully understood but involves NMDA antagonism, increased BDNF, and rapid synaptogenesis. Ketamine works within hours to days in treatment-resistant depression, whereas SSRIs take weeks. A sublingual form (orally disintegrating tablet) allows at-home dosing under physician guidance. Dissociation (feeling detached from body or surroundings) is expected; your physician prepares you.
What's in it
- KetamineActs on glutamate; fast mood effect
50-70%
response rate in treatment-resistant depression
Ketamine works when standard antidepressants do not. Doses range 0.5-1 mg/kg; sublingual forms are 2-10 mg. Response is rapid: hours to days, not weeks. Tolerance may develop with repeated use.
Is it right for you?
Who it's for
Adults with depression that did not improve with other treatments, under psychiatric care.
What sets it apart
It can act within hours. A controlled substance: a video visit is required.
Worth knowing before you start
Never alone and never before driving. A responsible adult stays with you for each dose.
What to expect
Rapid mood lift
depression relief within hours to days, not weeks
Suicidal thoughts quieter
immediate reduction in suicidal or self-harm urges
Renewed energy
motivation and mental clarity return quickly
Physician oversight
every dose is supervised; safety is monitored
How ketamine works
Day 1
Your physician reviews your depression history, failed antidepressant trials, psychiatric status, blood pressure, substance use history, and suicide risk. Discusses ketamine's rapid action, expected dissociation, and risks.
1Week 1
First ketamine dose under physician supervision or in an office setting. Take as sublingual tablet. Expect dissociation (feeling detached, mild hallucinations) for 30-90 minutes. Rest and recover with a designated person.
2Days 2-7
Mood and depression symptoms often lift significantly within 24-72 hours. Some people report euphoria; this fades. Continue your other psychiatric medications unless your physician advises otherwise.
3Weeks 2-4
Your physician assesses your mood and response. Additional ketamine doses may be given on a schedule (e.g., weekly initially, then as-needed). Discuss maintenance and long-term plans.
4Beyond
Ketamine is continued only if response is sustained and risk is acceptable. Your physician monitors your mental state, substance use risk, and continued need at every visit.
5
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
How you use it
This is the starting dose the pharmacy prints on the label. Your physician sets yours and adjusts it with you.
- How
- Dissolved under the tongue
- Dose
- 1 tablet (50 mg)
- How often
- Once a day
- Each shipment
- 30 tablets
- Pharmacy label
- Place 1 tablet (50 mg) under the tongue once daily as directed by your provider. Let it dissolve for 10 minutes, then spit; do not drive for 12 hours.
A sample week
- M
- T
- W
- T
- F
- S
- S
Once a day
Strengths the pharmacy carries
- 100 mg
- 50 mg
The science of ketamine and rapid antidepressant action
Ketamine produces rapid antidepressant effects in treatment-resistant depression in multiple randomized controlled trials. Dissociation is short-lived and dose-dependent; it is managed by physician dosing.
Long-term ketamine safety is emerging. The controlled setting and sublingual (not IV) dosing reduces risks. Abuse potential and cognitive effects with chronic dosing require careful monitoring and clear protocols.
Learn moreImportant safety information and common side effects
Ketamine is a controlled substance (Schedule III in the US). It is prescribed only for treatment-resistant depression under careful physician oversight. Dissociation (feeling detached or hallucinating) is expected; your physician prepares you and controls the dose. Do not drive or operate machinery for 6-8 hours after dosing. Do not use ketamine if you have active or recent psychosis, uncontrolled high blood pressure, or hyperthyroidism. Tell your physician about any history of substance use, suicidal ideation, or psychosis. Ketamine carries abuse potential; use only as prescribed in a monitored setting. Stop and seek emergency care for severe dissociation, chest pain, very high blood pressure, or confusion lasting beyond expected time.
Every plan includes
- Personalized, physician-guided plan
- Monthly and 3-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
How it works
1.Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
2.Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
3.Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Ketamine educational content reviewed by our physician
Scott Nass, MDDoctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
Frequently asked questions
How do I take Ketamine ODT?
Dissolved under the tongue, once a day. The starting prescription is 1 tablet (50 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Ketamine ODT come in?
The pharmacy carries 2: 50 mg, 100 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Is it a controlled substance?
Yes. The law requires a live video visit with the physician before it can be prescribed.
Is ketamine safe for depression?
Ketamine has strong evidence for treatment-resistant depression when prescribed and monitored by an experienced physician. The rapid antidepressant effect can be life-saving in severe cases. Dissociation, abuse risk, and cognitive effects require close oversight. Ketamine is not a first-line treatment; it is reserved for people who have not responded to standard therapy.
How fast does ketamine work?
Many people feel relief within hours to a day. Some feel changes within minutes of the first dose. Unlike SSRIs, which take 4-6 weeks, ketamine acts rapidly. The effect may plateau or fade over days; your physician decides on repeat dosing.
What is dissociation?
Dissociation is a temporary detachment from your body or surroundings. You may feel floating, see mild visuals, or lose track of time for 30-90 minutes. It is expected, reversible, and managed by dose. Your physician prepares you and stays present during dosing.
Can I become addicted to ketamine?
Ketamine has abuse potential. Use only as prescribed, in a monitored setting, by your physician. Avoid driving or operating machinery for 6-8 hours after a dose. Report any urge to use ketamine outside of medical supervision immediately.
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The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Individual results vary.
Sources
- 1
Ketamine for treatment-resistant depression: a systematic review and meta-analysis.
J Psychiatr Res, 2020 - 2
Rapid-acting antidepressants: implications for clinical practice and drug development.
Nature Rev Neurosci, 2021
Ketamine ODT (Orally Disintegrating Tablet)from $219/mo