Which Type of Ketamine Therapy Is Right for You?

I’ll be honest, if someone had asked me five years ago what ketamine was, I would’ve said, “Wasn’t that a party drug from the ’90s?” I didn’t know much about it. I definitely didn’t know it was quietly changing the lives of people with treatment-resistant depression, PTSD, chronic pain, and more.

But then a close friend, let’s call her Sara, was battling severe depression. She’d tried every antidepressant under the sun, therapy after therapy, meditation retreats, and even dietary overhauls. Nothing touched the darkness. It wasn’t until she started ketamine therapy that things shifted. That experience pulled me into the world of psychedelic medicine, not just as an observer, but as someone who needed to understand the options and the science behind them.

Because, let’s face it: when you or someone you love is suffering, you don’t want guesses. You want clarity. So, if you’re wondering which type of ketamine therapy is right for you, let’s walk through this together.

First, What Is Ketamine Therapy, Really?

Ketamine is a dissociative anesthetic that’s been used safely in operating rooms since the 1970s. But researchers noticed something surprising: it worked fast, within hours, sometimes minutes, to relieve depressive symptoms. That sparked decades of studies, and now, ketamine is being used off-label (and legally) for mental health and pain conditions across the U.S.

Unlike traditional antidepressants that take weeks to show effects, ketamine targets the NMDA receptors in your brain, helping reset neural pathways that have been damaged by chronic stress, trauma, or depression.

The Different Types of Ketamine Therapy

So, how do you actually take it? Well, there’s no one-size-fits-all answer. The right form depends on your condition, access, budget, and comfort level. Here's a breakdown of the four most common types- and who they might be best for.

1. IV Ketamine Infusions

Best for: Severe depression, suicidal ideation, PTSD

This is the most well-studied and clinically monitored form of ketamine therapy. Delivered via an intravenous drip in a medical setting, the dose is precise and the effects are fast, many people report relief within hours of their first or second session.

Pros:

• High absorption rate
• Supervised by medical professionals
• Ideal for patients with acute symptoms

Cons:

• Expensive ($400–$800 per session, not usually covered by insurance)
• Requires a clinic visit (usually 1–2 hours per treatment)

My Take:

Sara began with IV infusions. She said it felt like pressing a “reset button” in her mind. The experience was deep and a little strange at first, but she walked out of the clinic feeling something she hadn’t in years: lightness.

2. Intramuscular (IM) Ketamine Injections

Best for: Those wanting flexibility with fast results

IM injections deliver ketamine into the muscle, usually the arm or thigh. It’s faster than lozenges, cheaper than IV, and still has a potent therapeutic effect. It’s often used in clinics with trained mental health professionals nearby.

Pros:

• Cheaper than IV
• Rapid onset (within 15–30 minutes)
• Can be paired with talk therapy

Cons:

• Less control over dose adjustments
• Some discomfort with injections

My Take:

This option is gaining popularity, especially for clinics without IV infrastructure. For people who prefer something less “hospital-like,” IM therapy offers a more personal, low-fuss experience.

3. Ketamine Lozenges (Sublingual or Oral)

Best for: Mild to moderate depression, at-home treatment seekers

This is where ketamine gets more accessible. With a prescription, some people take ketamine lozenges at home under virtual supervision or after initial clinical sessions. They’re held under the tongue for absorption.

Pros:

• More affordable ($100–$250/session)
• Convenient, often part of virtual therapy programs
• Gentler experience for first-timers

Cons:

• Lower bioavailability (~30%)
• Not ideal for severe depression or suicidal thoughts
• Can vary in effect depending on how it's absorbed

My Take:

If you’re just starting to explore ketamine therapy and don’t need intensive intervention, lozenges can be a great entry point. But make sure you’re supported by professionals, it’s not just about taking a pill and hoping for the best.

4. Esketamine Nasal Spray (Spravato®)

Best for: Patients needing insurance coverage and FDA-approved options

Spravato is the only FDA-approved ketamine-derived treatment for depression, prescribed alongside an oral antidepressant. It’s taken under supervision at certified clinics and usually covered by insurance.

Pros:

• FDA-approved
• Often covered by insurance
• Effective for treatment-resistant depression

Cons:

• Must be used with an antidepressant
• Effects are milder compared to IV or IM
• Requires frequent clinic visits

My Take:

If affordability is a barrier, Spravato is a solid choice. It’s also a good option if you or your doctor are more comfortable sticking with FDA-sanctioned treatments.

However, some patients report less “breakthrough” compared to traditional ketamine.

So, Which One Is Right for You?

It depends on your needs.

• If you’re in crisis or battling long-term, severe depression → IV or IM might be your lifeline.
• Want convenience and mild to moderate relief → Lozenges are low-barrier and gentle.
• Need insurance coverage and prefer an FDA-approved method → Spravato may be the path.

And don’t forget the therapy component. The psychedelic effects of ketamine are powerful, but integration therapy, where you talk through your experiences, is where the lasting healing often happens.

Final Thoughts

Choosing the right type of ketamine therapy can feel overwhelming. It's a deeply personal decision, shaped by your body, mind, and life circumstances. I’ve been there, watching someone I love navigate the options, trying to decide what was worth the risk, what felt safe, what offered hope.

What I’ve learned is this: ketamine isn’t magic, but it’s opening doors that used to feel locked shut.

If you're searching for support, and you're based in the Keystone State, there are compassionate clinics offering ketamine therapy in Pennsylvania, with professionals who genuinely care about your journey, not just your symptoms.

Because healing isn’t just about getting better. It’s about finding your way back to yourself.