A practical, no-fluff guide for first-time patients. Checklist, cost estimator, legality lookup — everything you should know before your first appointment.
Open the intake checklistintake.icu is a free, practical resource for people preparing for their first ketamine treatment. We don't sell treatment. We help you arrive prepared, ask better questions, and understand what your clinic will assume you already know — fasting rules, medications to disclose, transportation, integration practices, and the regulatory backdrop.
Tick items as you complete them. Save your progress. Print or copy to send to a partner or support person.
SSRIs, MAOIs, benzodiazepines, lamotrigine, lithium, opioids — what your clinic actually wants to know.
Walk into the call with a realistic price range and the right questions about insurance.
What to do in the 1–14 days after dosing to make the most of the plasticity window.
Interactive. Saves locally. Print or copy to share with your support person.
Bring a complete list. Some medications interact with ketamine or blunt its effect.
General checklist for educational use. Your clinic's instructions take precedence. Information, not advice.
IV, Spravato, IM, sublingual — compare setting, cost, coverage, and protocol.
| IV ketamine | Spravato (esketamine) | IM ketamine | Sublingual lozenge | |
|---|---|---|---|---|
| FDA status | Off-label (Schedule III anesthetic) | FDA-approved 2019 for TRD; 2020 for MDD with acute suicidality | Off-label | Off-label, compounded |
| Setting | In-clinic, IV pump, monitored | REMS-certified clinic, 2-hr observation | In-clinic injection, monitored | At home (often telehealth-prescribed) |
| Typical dose | 0.5 mg/kg over 40 min | 56 mg or 84 mg nasal spray | 0.5–1.0 mg/kg | 100–400 mg sublingual |
| Induction protocol | 6 sessions over 2–3 weeks | 8 sessions over 4 weeks (2×/week) | 4–6 sessions over 2–3 weeks | Variable; weekly to 3×/week |
| Maintenance | Boosters every 2–6 weeks | Weekly then biweekly per label | Boosters every 3–6 weeks | Variable, prescriber-directed |
| Insurance coverage | Rare; usually cash-pay | Most commercial, Medicare Part B, most Medicaid (PA required) | Rare; usually cash-pay | Rare; usually cash-pay |
| Typical cost / session | $350–$950 cash | $0–$200 with insurance; $600–$1,200 cash | $200–$575 cash | $150–$425 cash (plus Rx) |
| Driving | No driving for 24 hr | No driving for 24 hr (REMS rule) | No driving for 24 hr | No driving for 24 hr after dose |
| Onset of response | Within hours to days | Within hours to days | Within hours to days | Slower; days to weeks |
Information only — not a treatment recommendation. Best modality depends on diagnosis, insurance, and clinician assessment. The FDA has approved only Spravato (esketamine) for psychiatric use; IV, IM, and lozenge ketamine are prescribed off-label.
By state, treatment type, and number of sessions.
Information, not advice. Cost ranges are typical published per-session ranges and may not reflect a specific clinic. Consult a licensed provider for an individualized quote.
State medical board, telehealth status, REMS requirements.
Information only. Regulations change. Confirm current rules with the state medical board and DEA before booking treatment.
Information, not advice. Always consult a licensed clinician before starting treatment.
Plan for 90–120 minutes for IV ketamine: intake, vitals, the 40-minute infusion, and 30–45 minutes of recovery. Spravato sessions are typically 2.5 hours: dosing plus the required 2-hour REMS monitoring.
Generally no — most ketamine clinicians ask you to continue your existing regimen unless they recommend otherwise. Never stop a psychiatric medication without your prescriber's guidance. Always disclose every medication you're taking.
No. Spravato has an absolute 24-hour no-driving rule under its REMS program. IV and IM ketamine clinics also prohibit driving for the rest of the day. Arrange a driver in advance; do not plan to use rideshare alone for your first session.
Spravato is the FDA-approved esketamine nasal spray (2019, treatment-resistant depression; 2020, MDD with acute suicidality). IV ketamine is generic racemic ketamine used off-label. Spravato is typically covered by insurance; IV is usually cash-pay. See the treatment comparison tool above.
Ketamine transiently raises blood pressure. Most clinics screen for cardiovascular risk and may decline treatment if blood pressure is uncontrolled. Disclose any cardiovascular history during intake; the clinic may want recent labs or a cardiology clearance.
You may experience dissociation — a sense of detachment from your body or surroundings. This typically peaks during the dose and resolves within an hour. Frank hallucinations are less common at therapeutic doses. The clinical team is present throughout.
A common induction protocol is 6 IV sessions over 2–3 weeks, or 8 Spravato sessions over 4 weeks (2×/week). Maintenance varies widely — some patients have boosters every 2–6 weeks, others go months between sessions. Your clinician will personalize this.
Run through the checklist, estimate your cost, and review your state's rules. Then ask the clinic the questions above before you book.
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