Physician-led care for depression that has not responded to standard treatment. We explain what the evidence shows, what it does not show, and when this is not the right option.
Depression is common and treatable. An estimated 322 million people in the world have it, and psychological treatment and medicines are both effective.¹ When a first treatment does not work, the next step needs a careful review.
Our in-house physicians and nurse practitioners review your history, your current medicines and your safety before anything is prescribed. Ketamine is not a first-line treatment for depression,¹ and it does not replace therapy or crisis care.² If you are in crisis, call or text 988 in the US, or call 911.³
after a single intravenous dose, suicidal ideation fell in 167 people across 10 controlled trials. The benefit was still measurable up to a week, and the authors called the evidence preliminary.
Wilkinson ST et al., Am J Psychiatry, 2018of 22 outpatients taking ketamine by mouth (1 mg/kg three times a week for 21 days) reached remission, versus none of 19 on placebo, in a randomized trial in depression that had not responded to standard treatment. It is a small trial.
Domany Y et al., Br J Psychiatry, 2019average fall on the MADRS depression scale at day 21 with oral ketamine, versus 2.49 points on placebo, in the same 41-person trial. The authors reported side effects as mild and short-lived.
Domany Y et al., Br J Psychiatry, 2019The longest randomized trial of oral ketamine for depression lasted six weeks, and the reviewed studies include no long-term maintenance data. UIC College of Pharmacy review, 2022
Trial results are averages from specific doses and routes, in small groups, and they are not predictions for you. The intravenous result comes from a different route and dose. Oral ketamine has no commercial formulation, so it is compounded from the injectable form, and compounded products are not FDA-approved.
When standard treatment has not worked, you should not have to guess what comes next. Our physicians review your history, your safety and your current treatment, and they tell you plainly whether oral ketamine is a reasonable option for you.
We review your history and your safety first, we explain what the evidence does and does not show, and we follow up with you while you take it, with plans starting at $219 a month.
Start hereKetamine is studied in several forms, and each one gives different evidence. We read the trials, state their size and length, and say where the evidence stops.
Real products and real prices from our pharmacy. Your physician helps you choose the medicine, the form and the dose.
Dissolves under the tongue. No needles.
Dissolving tablet
Ketamine dissolving tablets (oral) for treatment-resistant depression and mental health support. A controlled substance requiring synchronous audiovisual monitoring. Prescribed and dosed by a licensed physician.
30 tablets per month
Starting at $219/mo
1 treatments in this area, all from our live catalog.
No. Oral ketamine is prescribed off-label, and the compounded product is not FDA-approved. The approved ketamine-family medicine for treatment-resistant depression is esketamine nasal spray (Spravato), which is given in a certified clinic.
The evidence is limited. In one small randomized trial of 41 outpatients, 27.3% of those on oral ketamine reached remission at day 21, versus none on placebo. Most oral trials are small and short, and a review found the pooled benefit only marginally better than placebo.
People with a history of psychosis, uncontrolled high blood pressure, certain heart or brain conditions, or a current substance use disorder should not use it. Our physicians also review pregnancy, breastfeeding and your full history before any prescription.
Not on the day of treatment. The UK leaflet for Spravato advises waiting until the next day after a restful sleep before driving or operating machinery, and we give you the same advice for oral ketamine.
Ketamine does not replace crisis care. If you have thoughts of harming yourself, call or text 988 in the US, the 988 Suicide and Crisis Lifeline, at any hour. If you are in danger right now, call 911.
Oral ketamine is compounded and prescribed off-label. Compounded medications are not FDA-approved, and the FDA has not reviewed them for safety, efficacy or quality. Ketamine is not a replacement for therapy or crisis care. If you are thinking about harming yourself, call or text 988 in the US or call 911. Individual results vary.
