Last updated: October 2026. Reviewed by Dr. Steven Radowitz.
If you’ve tried two or more antidepressants and still don’t feel like yourself, you may be wondering whether IV ketamine in NYC is the next step. “IV” stands for intravenous, meaning it’s given through a vein. Ketamine is a medicine the FDA approved as an anesthetic, the kind used to put people to sleep for surgery; it isn’t FDA-approved for depression, though doctors can prescribe it for that. Whether it’s right for you depends on how your current treatment is going, your health, and how soon you need relief.
How do you know if your antidepressant is working “enough”?
That’s something you and your prescriber work out together, and doctors use one clear marker: treatment-resistant depression is when someone doesn’t get better after trying at least two antidepressants. The name describes how the depression has responded to medicine. It isn’t about you.
About 11% of adults in New York City have been diagnosed with major depression, and about a third say they have mental health needs that aren’t being met, according to the city’s first State of Mental Health report. Across the US, a 2021 analysis estimated that about 2.76 million adults live with treatment-resistant depression.
What would IV ketamine add that you haven’t tried?
IV ketamine adds speed. It works differently from a standard antidepressant: it appears to help the brain form new connections, starting as early as four hours after a dose. That’s why some people feel a change within hours or days, while a new antidepressant usually takes four to eight weeks to work.
You receive it as a slow drip into a vein, called an infusion, while a medical team looks after you. Using ketamine for depression is called “off-label,” which simply means a doctor prescribes an approved medicine for a different use. Nushama’s page on ketamine’s FDA status and off-label use explains more.
What does the research say, in plain terms?
The research shows IV ketamine helps a good share of people whose depression hasn’t lifted. In a 2023 study of about 400 adults whose depression hadn’t lifted with other treatments, IV ketamine cut symptoms at least in half for 55% of people. That’s a little over half.
In a 2022 study of people treated in community clinics, about half saw the same level of improvement after six infusions. Results differ from person to person, so it helps to decide with a clinician who knows your history.
Do you have to choose between ketamine and your antidepressant?
Often, no. Before anything starts, the care team looks at every medicine you take. Many can stay as they are; some, such as sedatives, opioids or thyroid medicine, may interact with ketamine and need adjusting.
You, the care team and your prescriber decide together. Please don’t stop or change any medicine on your own: stopping an antidepressant can bring short-term symptoms like dizziness or nausea.
When might it be time to consider IV ketamine?
It may be time if one or more of these sounds like you:
- Two or more antidepressants haven’t brought enough relief.
- You need relief sooner than another four-to-eight-week medication trial allows.
- Your depression comes with anxiety; the 2022 community-clinic study also tracked anxiety symptoms.
- You’d like preparation before each session and integration after it, meaning time with a trained guide to make sense of the experience.
When might a different option be a better fit?
A different option may suit you better if certain health conditions apply or you’re in crisis right now:
- Certain health conditions apply. Uncontrolled high blood pressure, some heart problems, pregnancy, breastfeeding or a history of psychosis may rule it out. Psychosis means losing some contact with reality. Nushama’s screening checks for these before recommending any treatment.
- You’re in crisis right now. If you’re thinking about suicide or feel unsafe, go to the nearest emergency room or call or text 988 first. A consultation can come later.
At Nushama, a medical team monitors you closely through every infusion, because ketamine can cause dissociation, a feeling of being detached, floaty or dreamy, and can raise your blood pressure. The detached feeling typically fades within one to two hours. Having that support in the clinic matters: the FDA has warned that taking ketamine at home, without a clinician on site to monitor you, carries added risks.
What should you ask before you decide?
Bring these five questions to your prescriber or your consultation:
- Have my antidepressants had a fair chance, at the right dose and for long enough?
- Would IV ketamine be added to my current medicines, or would anything need to change?
- Is there anything in my health history that would make it a poor fit?
- How many infusions might I need, and how will we know if it’s helping?
- Can my own therapist or psychiatrist stay involved?
On that last question, Nushama’s guide to keeping your therapist in the plan explains how it works.
FAQ
Do I have to be “severely” depressed to try IV ketamine? No. What matters is whether your depression hasn’t lifted enough with other treatments, and whether ketamine is safe for you. Your consultation looks at both.
How many infusions does a series usually involve? A series is a set of infusions spaced over a few weeks. At Nushama, it’s often six infusions over three to six weeks, tailored to you by your care team. They’ll check in on your progress along the way.
Can I use sick leave for infusions in NYC? Usually, yes. Under New York City’s protected time off law, most workers can use their leave to get medical care, and you don’t have to tell your employer why you used it.
What’s the first infusion actually like? Nushama’s first-session walkthrough covers the day itself, from arrival to the ride home.
Can I try Spravato or TMS instead? Yes. Spravato is an FDA-approved nasal spray made from esketamine, a close relative of ketamine. TMS, or transcranial magnetic stimulation, uses magnetic fields to stimulate nerve cells in a part of the brain involved in mood. Your care team can help you compare all three.
How can Nushama help you decide on IV ketamine in NYC?
Nushama starts with a conversation about your history, what you’ve tried and what you want from treatment. Because Nushama also offers Spravato and TMS, the team can help you weigh all three and recommend the one that fits you. If IV ketamine is the right fit, each infusion comes with medical screening, close monitoring, and preparation and integration support.
The Manhattan center is at 515 Madison Avenue, 21st floor, in Midtown, with the entrance on East 53rd Street. It’s steps from the 5 Av/53 St subway station (E train, plus the F on weekdays), a short walk from the 6 at 51 St, and on the M1, M2, M3 and M4 bus routes. Nushama’s Rockland County center in New City also offers IV ketamine. When you’re ready, book a free consultation with Nushama’s care team.
If you’re in crisis or feel unsafe, please don’t wait for a consultation. Call or text 988, the 988 Suicide & Crisis Lifeline, or go to the nearest emergency room. In New York City, NYC 988 also offers call, text and chat support in more than 200 languages.
