etamine should not be administered to patients experiencing active mania, hypomania, or psychosis, as its psychoactive properties may worsen these symptoms and lead to negative outcomes.

For individuals with bipolar disorder, ketamine therapy may be considered during periods of bipolar depression, but only when the patient is in remission from manic or hypomanic states.

Before starting treatment, your AVYIA provider will carefully evaluate your current medical and psychiatric status to determine whether ketamine is appropriate and safe for you at that time.

While ketamine can be effective through multiple routes, the experience, onset, and intensity of effects vary depending on how it’s administered.

Intravenous (IV) ketamine is considered the gold standard, as it delivers 100% of the medication directly into the bloodstream. This route allows for precise dose control and a steady, consistent infusion, resulting in a smoother therapeutic experience. It typically requires 6 sessions over 2–3 weeks.

Intranasal administration offers a needle-free option and has a faster, more abrupt onset of effects. While it avoids IV access, it generally requires 8 sessions to match the efficacy of IV therapy. Both routes—IV and intranasal—can achieve similar results by the end of the full treatment program. The choice often depends on patient preference, comfort, and clinical considerations.

Intramuscular (IM) ketamine involves a single injection into the muscle and provides rapid absorption and high bioavailability. Like intranasal, it typically requires 8 sessions and is a great alternative when IV access is difficult or when shorter in-home or in-clinic  visits are preferred.

Oral microdosing follows a different therapeutic approach. Patients take low daily doses using sublingual (under the tongue) tablets to avoid dissociative or psychedelic effects. While the onset of symptom relief may be slower compared to IV, IM, or intranasal routes, many patients still report feeling better within the first few days, and in some cases, even after the first dose.

Results vary from patient to patient, but current research shows promising outcomes for individuals with bipolar depression (the depressive phase of bipolar disorder).

When reviewing the most recent body of scientific literature on ketamine infusions, approximately 60–80% of patients reported mood improvement after multiple treatments. A 2020 review by Wilkowska et al. reported a 63.2% to 73.7% remission rate following six low-dose ketamine treatments. In contrast, single-session treatments were less effective, highlighting the importance of completing a full treatment protocol.

At AVYIA, we also recommend combining ketamine infusions with ketamine-assisted psychotherapy (KAP)—a therapeutic approach that includes individualized sessions with a licensed therapist. This integrated model is designed to enhance and sustain the positive effects of ketamine treatment for bipolar depression.

AVYIA’s daily microdosing ketamine program is comparable in cost to many standard mental health therapies, yet it has the potential to deliver equal or even superior results—often with a better safety profile. Traditional treatment approaches frequently involve multiple doctor visits, medication trials, and long-term prescriptions, which can significantly increase both time and medical expenses.

While ketamine infusions, injections and nasal spray may carry a higher upfront cost compared to a typical doctor’s visit or medication copay, the potential for rapid and lasting relief from chronic depression can make it a worthwhile investment. When factoring in the impact of untreated depression on work performance, relationships, and quality of life, achieving remission quickly becomes more than just a medical goal—it becomes a valuable investment in your future well-being and happiness.

Yes — ketamine is safe when administered under the supervision of a trained clinician. Since its introduction into clinical trials in the 1990s, low-dose ketamine infusion therapy has consistently been shown to be both safe and effective in treating depression and other mental health conditions. Ketamine has been FDA-approved since the 1970s as an anesthetic, and even at higher anesthetic doses, it has demonstrated a strong safety profile.

Ketamine can induce psychedelic or dissociative effects, which are typically short-lasting. However, patients should not drive or engage in potentially dangerous activities while under the influence. For IV and intranasal treatments, AVYIA requires that a responsible adult be present to accompany and monitor the patient after each session.

Certain medical and psychiatric conditions may contraindicate the use of ketamine, which is why a comprehensive medical screening with AVYIA’s clinicians is required before starting treatment.