Questions to Ask a Psychiatrist About Ketamine Therapy

You should ask a psychiatrist whether ketamine fits your diagnosis, treatment history, health risks, treatment setting, expected costs, and plan for follow-up care. Ketamine is prescribed off-label for depression and most mental-health uses, while esketamine nasal spray, sold as Spravato, is FDA-approved for treatment-resistant depression and certain adults with major depressive disorder with acute suicidal ideation or behavior. A first consultation should help you make an informed decision, not pressure you toward treatment.

Bring a list of your current medications, past treatments, medical conditions, substance-use history, and goals. These questions to ask before ketamine therapy can help you organize the broader conversation.

Ask whether ketamine matches your condition and treatment history

Start with the clinical reason for considering treatment. Ketamine has the strongest body of research for treatment-resistant depression, but research and real-world practice vary for anxiety, post-traumatic stress disorder, chronic pain, and other conditions. The American Psychiatric Association consensus statement describes ketamine as a treatment that requires careful assessment, informed consent, and monitoring, rather than a simple next step for every person with depression.

• What diagnosis and symptoms are you trying to treat in my case?
• Which treatments have I tried adequately, and what options should I still consider first or alongside ketamine?
• What does the evidence say for someone with my diagnosis and history?
• What would count as meaningful improvement for me?

If eligibility is your main concern, use these ketamine treatment eligibility questions alongside your consultation notes.

Ask how safety screening and supervision will work

A psychiatrist should review more than your mood symptoms. Ask about blood pressure, heart or vascular history, pregnancy considerations, psychosis or mania history, substance-use concerns, medication interactions, and whether you have reliable support after a session. The FDA warns that compounded ketamine products can carry risks including sedation, dissociation, increases in blood pressure, respiratory depression, and misuse or abuse, and says monitoring is important.

• What findings would make ketamine unsuitable or mean we should postpone it?
• How will you assess my risk of mania, psychosis, or substance-related problems?
• What side effects require urgent help, and who do I contact after hours?
• Will you coordinate with my primary care clinician, therapist, or existing prescriber when appropriate?

Ask what the treatment plan will look like after the first session

Ketamine treatment is a course of care, not only a single appointment. Ask how often you will be reassessed, how symptom changes will be measured, what role therapy or other treatments may play, and how your clinician will decide whether to continue, change, or stop. Before setting goals, review these questions to ask about ketamine treatment goals at a first consultation.

Ask directly: “If I do not improve, what will we do next?” A clear answer should include a follow-up schedule, a way to assess benefit and side effects, and a continuity plan. For later appointments, keep these questions to ask at a ketamine follow-up visit when a dose isn't working available.

Ask who is responsible for your care and what you will pay

Provider oversight matters as much as the treatment description. Ask whether the psychiatrist will personally evaluate you, how often you can reach them, who handles urgent concerns, and whether another clinician may take over your care. You can also review how psychiatrist and nurse practitioner roles differ at ketamine clinicshow to verify a ketamine provider's medical license, and questions about continuity of care.

Request a written estimate before you commit. Ask what insurance may cover, whether the initial psychiatric evaluation is separate, whether monitoring and follow-up are included, and what you would pay if the plan changes. Honest answers should distinguish confirmed costs from estimates.