Ketamine is an anesthetic that, at much lower doses, is used off-label for depression that hasn’t improved with other treatment. MultiGen Wellness prescribes it as sublingual tablets or troches that dissolve under the tongue, after screening and a provider visit. This form isn’t FDA-approved for depression, and it isn’t right for everyone.
If you are in crisis or thinking about suicide, call or text 988 (Suicide & Crisis Lifeline) now, or go to the nearest emergency room. At-home ketamine is not an emergency treatment.
ketamine at a glance
| What it is | An NMDA receptor blocker, used as an anesthetic since 1970. |
|---|---|
| Forms we prescribe | Sublingual rapid-dissolve tablets and troches. |
| How it’s taken | Dissolved under the tongue at home, on a schedule and dose limit your provider sets. |
| FDA status | FDA-approved as an anesthetic. Using it for depression is off-label. A related nasal spray, esketamine (Spravato), is FDA-approved for treatment-resistant depression but can only be given in certified clinics. |
| Controlled substance | Yes, Schedule III. |
| Cost | Medication is priced separately from visits. See current prices on our pharmacy page. |
How ketamine works for depression
Most antidepressants act on serotonin and take weeks to help. Ketamine works differently. It blocks NMDA receptors, which triggers a burst of activity from glutamate, the brain’s main signaling chemical, and is thought to help brain cells form new connections.
In studies of IV ketamine, some people with treatment-resistant depression felt better within hours to days, though the effect often fades without repeat doses. Sublingual forms have been studied much less than IV ketamine, and how much gets absorbed varies from person to person.
Who it may help
- Adults whose depression hasn’t improved after trying at least two antidepressants
- People already working with a therapist or prescriber who want another option alongside that care
- Adults who can take doses at home in a safe, quiet place with another adult nearby
Who should not take ketamine
- Anyone with uncontrolled high blood pressure, or a history of heart disease, aneurysm or stroke
- A personal history of psychosis, schizophrenia or mania
- Current or past problems with alcohol, ketamine or other drug misuse
- Pregnancy or breastfeeding
- Severe liver disease
- Anyone having thoughts of harming themselves right now, who needs urgent in-person care. Call or text 988.
Side effects
Common effects start soon after a dose and usually fade within 1 to 2 hours: feeling detached or dreamlike (dissociation), dizziness, blurred vision, nausea, sleepiness, and a short rise in blood pressure and heart rate.
Less common but serious: bladder irritation and urinary problems with frequent or heavy use, and misuse or dependence. Ketamine is a controlled substance because it can be misused.
Safety rules for at-home doses
- Take each dose sitting or lying down in a quiet room.
- Have another adult nearby, at least for your first several doses.
- Don’t drive, use machinery or make big decisions for the rest of the day.
- Don’t combine it with alcohol, benzodiazepines, opioids or sleep aids unless your provider has approved it.
- Store it locked up and away from others.
In October 2023, the FDA warned about the risks of compounded ketamine used at home without monitoring. That’s why screening, dose limits and follow-up visits are part of every ketamine plan we write.
Ketamine and telehealth rules
Because ketamine is a controlled substance, online prescribing depends on federal telemedicine rules and your state’s laws. The DEA’s temporary telemedicine flexibilities currently run through December 31, 2026. Your provider will explain what applies where you live. Low mood can also be tied to hormones; see low testosterone and depression.
How to get ketamine through MultiGen Wellness
- Book a free 15-minute consult. Pick a time online or call 1-800-259-0015. We go over your symptoms, goals and medical history.
- Labs and a provider visit. A licensed provider reviews your history and lab results and decides whether ketamine is a safe fit. Getting started is $247, which includes your first provider visit. Follow-up visits are $97 each, with no monthly membership.
- Medication shipped to your door. If it’s prescribed, a state-licensed partner pharmacy ships it to you. Your provider follows up with labs and visits to adjust the plan.
Frequently asked questions
Is sublingual ketamine as effective as IV ketamine?
It has been studied much less. Less of the drug is absorbed under the tongue, and absorption varies, so doses and results differ from IV treatment.
How fast does ketamine work?
Some people notice a change within hours to days. Others do not respond. Your provider tracks your symptoms and stops treatment if it is not helping.
Is ketamine addictive?
It can be misused, which is why it is a Schedule III controlled substance. Screening, dose limits and follow-up lower the risk, and people with a history of substance misuse usually are not good candidates.
Can I keep taking my antidepressant?
Many people in ketamine studies kept taking theirs. Your provider reviews everything you take, because sedatives such as benzodiazepines and opioids add to ketamine effects.
Other medications we prescribe
This page is for education and isn’t medical advice. Only a licensed provider who has reviewed your history and labs can decide whether a medication is right for you. Availability depends on your state. Last reviewed November 7, 2026.
Want to talk it through with our team?
Book a free 15-minute video consult. $197 if you sign up the same day as your consult, normally $247, and that includes your first doctor visit. No membership.