You finished your initial series of ketamine treatments and you’re feeling better. Maybe much better. Then a question starts to creep in: What happens if it fades? When should I come back? Are there reasons I shouldn’t?
Booster sessions (sometimes called maintenance treatments) are single sessions given after your initial series to help keep the benefits going. For many people, they’re an important part of long-term care. But timing matters. Here’s how to think about when a booster makes sense, and when it might not be the right move.
This guide focuses on IV ketamine boosters, whether you’re seen in Manhattan, Rockland, or Aventura. IV ketamine is ketamine given through a small intravenous line, which lets the medical team adjust or stop the dose at any point.
Why boosters exist
Ketamine can bring relief quickly, but for many people that relief doesn’t last on its own. Depression and anxiety are often recurring conditions, and symptoms can gradually return over weeks or months. This is true of treatment-resistant depression in general. In the National Institute of Mental Health’s STAR*D trial, relapse during follow-up was more likely among people who had needed more treatment steps to get well.
Ketamine research points in a similar direction:
- A 2020 randomized, double-blind trial by Shiroma and colleagues, published in Translational Psychiatry, reported a median time to relapse of about six weeks after a six-infusion series.
- A 2021 systematic review in Advances in Therapy found that relapse after ketamine can come sooner, with a median of roughly two to four weeks.
- Among our own members, how long improvement lasts after the initial series varies from person to person. It depends on many factors, as our FAQ explains.
Research on maintenance supports the idea of staying ahead of relapse. The SUSTAIN-1 trial of esketamine (Spravato, the FDA-approved nasal spray related to ketamine), published in JAMA Psychiatry in 2019, followed people in stable remission. Among them, 26.7% of those who continued treatment relapsed, compared with 45.3% of those switched to placebo. More recently, a 2025 systematic review in the Journal of Affective Disorders found that regular maintenance dosing lowered relapse rates compared with variable protocols, and that adding psychotherapy may reduce risk further.
How often someone needs a booster varies a lot. Some members come back every few weeks, some every few months, and some rarely need one at all. To compare a fixed calendar with a plan guided by how you feel, see our guide to ketamine booster maintenance in Manhattan. Spravato follows its own schedule, which our article on long-term Spravato maintenance in Aventura covers.
Signs it may be the right time
Early symptoms are coming back. You don’t need to wait until you’re back where you started. The first signs are often subtle:
- changes in sleep
- less motivation
- withdrawing from people
- losing interest in things you enjoyed
- a familiar heaviness returning
Noticing these early and reaching out is exactly what a booster is for.
A predictable stressor is ahead. A difficult anniversary, a major life transition, the start of winter, or a high-pressure stretch at work are all times when a planned booster may help you feel more supported going in. Reaching out ahead of time also gives your care team a chance to review how you’ve been doing.
Your care team recommends a schedule. Some members do best with regular maintenance sessions rather than waiting for symptoms. Your provider can help you figure out which approach fits your history and your life.
Your symptom scores are rising. You might be tracking your mood with the PHQ-9 (Patient Health Questionnaire-9), a widely used depression screener available free through the PHQ Screeners site. If you use it, a steady upward trend over several weeks is useful information to bring to your provider. A single high score on a bad day matters less than the direction over time.
When a booster may not be the right answer
You’re in crisis right now. If you’re having thoughts of suicide or feel unsafe, a booster appointment is not the place to start. Call or text 988, the Suicide & Crisis Lifeline, or go to your nearest emergency room. Then talk with your care team about next steps. Ketamine can have a role in care for suicidal thoughts, as our page on ketamine for suicidal ideation describes, and that care begins with a full evaluation rather than a quick booster.
You’re wanting sessions more and more often. You may notice the gap between boosters keeps shrinking, or that you want ketamine to escape a hard day rather than to treat a returning pattern. Either way, that’s worth raising with your provider. It may mean another part of your treatment plan needs attention, such as therapy, medication, sleep, or life stress. Mentioning it shows self-awareness, and your team will respond with care and without judgment.
Your health has changed. Several changes can affect whether ketamine is safe for you:
- new medications, including stimulants, benzodiazepines, lamotrigine, memantine, or opioids
- pregnancy, or plans to become pregnant
- blood pressure that isn’t well controlled
- changes in alcohol or substance use
Let your team know before booking so they can review your screening.
You’ve noticed signs of elevated mood. If you have bipolar disorder, tell your provider before another session. The same applies if you’ve ever had periods of unusually high energy, racing thoughts, or needing much less sleep than usual. Ketamine can still be part of care for some people with bipolar depression, though it calls for closer planning and sometimes a different sequence of treatment.
There’s no support around it. Ketamine works best alongside therapy, integration, and other care. Integration is the process of making sense of what came up during a session and turning it into changes in daily life. If a booster would be standing in for everything else, it’s worth rebuilding that support first. If you don’t have a therapist, finding one who works with psychedelic or ketamine-assisted care can be a good place to start. Our Aventura integration guide shows what that support can look like between sessions.
What a booster visit involves
A booster is a smaller commitment than a full series, and the safety steps stay the same. Before treatment, the medical team reviews your history and any changes since your last visit. Depending on your situation, this can include blood pressure checks and other testing. During the infusion, doctors and nurses monitor your vital signs and adjust the dose as needed.
Many people notice dissociation during an infusion, which means a sense of distance from your usual thoughts or body. Most people return to their ordinary awareness within an hour or two. Afterward, it’s best to have someone take you home; if that isn’t possible, you’ll be asked to show a booked car service. Integration support then helps you connect the experience to what you’re working on now. The Journey walks through each of these steps.
For members living with PTSD, boosters are one part of a longer plan. A 2025 study titled “Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm,” by MacConnel, Earleywine, and Radowitz, examined IV ketamine for PTSD in a real-world setting. Our page on ketamine for PTSD and trauma explains how that care is structured.
How to talk to your care team about it
You don’t need to have the answer figured out. Reach out and share what you’ve been noticing:
- how you’re sleeping
- how your mood has been
- what’s going on in your life
- how long it’s been since your last session
Your provider will help you decide whether a booster, a change in your treatment plan, or something else is the best next step. If you’re in the Hudson Valley, our overview of ketamine therapy in Rockland County explains how care works there.
Ready to book a booster, or not sure if it’s time? Contact your local clinic to schedule. If you have questions, you’re welcome to ask to speak with a provider at your location:
- Manhattan (515 Madison Avenue): Dr. Glatter, Jesse Erckert, Jessica Camacho, Alison Whelan, Karl Spoerri, or Elmina Saint-Loth
- Rockland: Rachel Singer, PA
- Aventura: Dr. Radowitz
The bottom line
The right time for a booster is usually before things feel unmanageable, when you first notice the old patterns returning. The wrong time is when a booster is being asked to do a job that needs more support, or when you need urgent help. Either way, your care team is there to help you figure it out.
If you’re thinking about suicide or are in crisis, call or text 988, available 24/7.
When you’d like to talk it through, book a consultation with our care team in Manhattan, Rockland, or Aventura.