The Science of
Ketamine Therapy
A breakthrough
decades in the making
It's not just
for horses.
Ketamine was approved by the FDA in 1970 as an anesthetic agent, and has since become one of the most widely used medicines in the world for surgical anesthesia, procedural sedation, and pain management in adults, children, and infants. Over time, an unexpected side effect of ketamine was observed: relief from depression. That understanding has been building quietly in research institutions for decades, and the results are among the most compelling in the history of psychiatry.
A fundamentally different mechanism
Traditional antidepressants like SSRIs, SNRIs, and MAOIs target the serotonin system. When the first SSRI (Selective Serotonin Reuptake Inhibitor) hit the market, it was heralded a a miracle treatment... but that was 1987. It's about time we expanded our repertoire.
Ketamine works on an entirely different system. It's an NMDA receptor antagonist, meaning it acts on the glutamate pathway, the brain's primary excitatory signaling system. This distinction means that ketamine reaches patients whose depression, anxiety, or PTSD has not responded to conventional pharmacological approaches.
Research suggests ketamine also promotes neuroplasticity— the brain's ability to form new neural connections. In conditions like depression and PTSD, certain neural pathways become entrenched and rigid. Ketamine appears to create a window of enhanced plasticity during which those unhelpful patterns can be interrupted and new ones established. This is one reason the therapeutic context surrounding ketamine administration is not incidental to outcomes, it is central.
Rapid relief, profound results
Ketamine Therapy
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Relief in hours or days
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70% of patients with treatment-resistant depression respond to ketamine therapy
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Side effects dissipate within hours of administration
Traditional Antidepressants
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Weeks to months until relief
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At least 30% of patients do not respond to traditional antidepressants
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Notorious side effect profile includes weight gain and sexual dysfunction
What we know, and what we're still learning.
We believe that intellectual honesty is part of responsible medicine. The evidence for ketamine's antidepressant and anti-suicidal effects is substantial and growing. The FDA approval of esketamine reflects a rigorous regulatory review of that evidence. But science is never finished, and we don't pretend otherwise.
The full mechanism by which ketamine produces its antidepressant effects is not yet completely understood. Long-term maintenance protocols are still being optimized. Research into the role of the psychedelic experience itself is ongoing. We follow this research closely, and our clinical protocols will evolve with it.
What we are confident in is this: for patients who have not found relief through conventional means, ketamine-assisted therapy represents a meaningful, evidence-based opportunity for relief when carried out by a team that takes both the science and the patient experience seriously.
Legal, regulated,
and well-trodden.
With the exception of esketamine (Spravato), ketamine is administered for psychiatric indications on an off-label basis. Off-label prescription is a standard and legal practice in medicine; it means a medication is being used for a purpose beyond its original FDA approval, based on clinical evidence and physician judgment. The majority of psychiatric medications are used off-label for at least some indications.
All patients at Transcend Medicine receive thorough informed consent documentation explaining the off-label nature of ketamine therapy, the current state of the evidence, and what to expect from treatment. We do not offer ketamine therapy as a cure. We offer it as a clinically supported option for people who deserve more than the treatments that haven't worked.
DISCLAIMER: Statistics cited reflect ranges reported across peer-reviewed clinical literature and may vary based on patient population and study design. Individual results vary. Ketamine is administered off-label for psychiatric indications at Transcend Medicine. All treatment is preceded by a thorough medical evaluation by a licensed provider. This page does not constitute medical advice.