When to Recommend IV Ketamine Therapy: A Guide for Therapists

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For many therapists, helping a patient with treatment-resistant depression, PTSD, or chronic pain can feel like planting seeds in soil that refuses to give. You’ve guided them through antidepressants, psychotherapy, lifestyle changes—and maybe even ketamine lozenges or intranasal ketamine. Some improve. Others plateau. And for a few, the weight remains just as heavy as the day you first met.

For those patients, it may be time to consider IV ketamine therapy—a more potent, highly bioavailable, and fast-acting form of ketamine treatment that has been changing lives worldwide.

Why IV Ketamine Therapy is Different

Not all ketamine treatments are the same. While oral and nasal routes can help, intravenous ketamine offers the highest bioavailability—nearly 100% absorption.

That means:

• More of the medicine reaches the brain where it can spark neuroplasticity

• Predictable dosing with consistent therapeutic levels in the bloodstream

• Faster onset, often with noticeable changes within minutes

For patients in deep crisis or those who have exhausted other options, this precision and potency can be a turning point.

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The Fast-Acting Benefits of IV Ketamine

One of the reasons IV ketamine treatment for depression has gained such attention is its speed.

• Mood improvements can begin in the first infusion

• Suicidal thoughts often reduce within hours

• Chronic pain patients may experience relief before leaving the clinic

While IV ketamine is not a magic cure, it can be the spark that breaks through mental fog and hopelessness—giving other therapies the chance to take root.

When Should a Therapist Recommend IV Ketamine?

Therapists are uniquely positioned to know when a patient’s progress has stalled. Here are the primary criteria for recommending IV ketamine infusions:

1. Treatment Resistance

• Failure to improve after at least two classes of antidepressants or mood stabilizers

• Ineffectiveness of adjunctive medications

2. Urgency of Symptoms

• Persistent suicidal ideation

• Severe depressive episodes threatening safety or daily function

• Disabling PTSD symptoms despite ongoing care

3. Functional Impairment

• Inability to maintain work, relationships, or self-care

• Extreme social withdrawal despite therapy

4. Inadequate Response to Other Ketamine Forms

• Limited benefit from ketamine lozenges or intranasal ketamine

• Effects that fade too quickly, leading to relapse

5. Medical Readiness

• No uncontrolled heart disease or contraindications

• Medically cleared for monitored infusions

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Your Role in the Transition to IV Ketamine

Referring a patient to IV ketamine therapy is not the end of your therapeutic role—it’s an expansion of it.

• Partner with an anesthesiologist or psychiatrist specializing in ketamine

• Maintain ongoing psychotherapy to help patients integrate changes

• Monitor symptom improvement and functional recovery alongside infusion care

Why This Matters Now

For patients trapped in severe depression or unrelenting PTSD, time is not a luxury. IV ketamine therapy can provide rapid relief and open a window for healing. Your recommendation could be the bridge between years of suffering and a meaningful new chapter in your patient’s life.

If you are a KAP trained therapist and would like to transition your patients to ketamine infusions reach out to us for collaboration. www.propeltherapeutics.com or call us (916) 915-9215

www.propeltherapeutics.com