Walking into your first ketamine therapy consultation marks a significant moment—you’re exploring a treatment approach that works differently from conventional antidepressants, and you likely have questions about what this actually involves. The consultation serves as your opportunity to understand whether ketamine therapy aligns with your treatment goals, what to realistically expect from the process, and how to prepare for success if you decide to move forward. Coming prepared with the right questions transforms this appointment from a passive information session into an active conversation about your care. Here are five essential questions to ask that will help you make an informed decision about ketamine therapy for treatment-resistant depression.
Question 1: “How Do You Determine If I’m a Good Candidate for Ketamine Therapy?”
This question opens crucial conversation about the evaluation process and helps you understand what factors your provider considers when recommending ketamine treatment. Research indicates that careful patient selection significantly impacts treatment outcomes, and comprehensive assessment forms the foundation of successful ketamine therapy (Rosenblat et al., 2022).
Your provider should explain that ketamine therapy typically serves patients who haven’t achieved adequate response to multiple antidepressant medications—usually defined as at least two different antidepressant trials at appropriate doses for sufficient duration. However, candidacy extends beyond just counting failed medication trials. The assessment should evaluate your complete psychiatric history, current symptom severity, any co-occurring medical or psychiatric conditions, substance use history, and current medications.
At Luvita, our comprehensive evaluation process includes detailed review of prior treatment attempts to distinguish true treatment resistance from situations where previous medications may not have received adequate trials. We assess medical factors that might affect ketamine safety, such as uncontrolled high blood pressure or certain heart conditions. We also explore your treatment goals, support system, and practical ability to attend regular appointments, since ketamine typically requires multiple sessions over several weeks. Our team’s 15+ years of experience in both military and civilian settings means we understand the complexity of treatment-resistant cases and can assess candidacy thoroughly.
Additionally, ask your provider to explain any contraindications—situations where ketamine might not be appropriate. These typically include certain cardiovascular conditions, active substance use disorders (particularly with stimulants), uncontrolled thyroid disease, and psychotic disorders. Understanding both what makes you a good candidate and what might complicate treatment helps you participate meaningfully in the decision.
Question 2: “What Should I Expect During and After Each Ketamine Session?”
Understanding the actual experience of ketamine therapy helps reduce anxiety and allows you to prepare appropriately. This question invites honest discussion about the treatment process, including effects you might experience and how your provider will support you throughout.
Ketamine produces what researchers call “dissociative effects”—temporary changes in perception that might include feeling disconnected from your body, altered sense of time, enhanced sensory experiences, or dreamlike states (Walsh et al., 2022). While these effects occur only during the session itself and typically resolve within an hour or two after treatment, knowing about them in advance prevents them from being frightening if they occur. Research suggests that sufficient preparation before ketamine sessions is crucial—patients who understand what to expect and approach treatment with appropriate mindset tend to have better therapeutic experiences (Grabski et al., 2020).
Your provider should explain the specific protocol they use. At Luvita, we administer ketamine infusion therapy intravenously in a comfortable, controlled medical setting where you’ll be monitored throughout the session. The infusion typically lasts 40-60 minutes, and you’ll remain conscious but deeply relaxed. We create a calm environment and provide support throughout the experience. Following the infusion, you’ll rest in our office for 30 minutes to an hour until the acute effects subside, and you’ll need someone to drive you home since you shouldn’t drive for the remainder of the day.
Ask also about the timeline for experiencing therapeutic effects. Some patients notice mood improvement within hours to days after the first session, though response varies considerably by individual. Research shows ketamine can produce rapid antidepressant effects, but results are not guaranteed and some people require multiple sessions before noticing significant improvement (Walsh et al., 2022). Setting realistic expectations prevents discouragement if immediate transformation doesn’t occur.
Question 3: “What Does the Complete Treatment Plan Look Like, and What Happens After the Initial Series?”
This question addresses the practical realities of committing to ketamine therapy—how many sessions you’ll need, over what timeframe, and what happens once you complete the initial treatment series. Understanding the full picture helps you evaluate whether this treatment fits your life circumstances and whether you can sustain the time and financial commitment.
Ketamine therapy typically begins with an initial series of sessions—commonly six infusions over 2-3 weeks, though protocols vary by provider. Your provider should explain their specific approach and the evidence supporting it. Research suggests that multiple sessions generally produce better outcomes than single administrations, and many patients benefit from maintenance sessions after the initial series (Grabski et al., 2020).
For Montana residents who may need to travel significant distances to access ketamine therapy, understanding the treatment schedule becomes particularly important. At Luvita in Helena, we work with patients throughout Montana, Wyoming, and Colorado to develop scheduling approaches that minimize travel burden while maintaining treatment effectiveness. This might include clustering appointments when possible or coordinating with local providers for follow-up care between sessions.
Ask about maintenance treatment as well. Research indicates that ketamine’s antidepressant effects may diminish over time for some individuals, and many people benefit from periodic maintenance sessions after completing the initial series. Your provider should discuss what follow-up care looks like, how they determine when maintenance sessions are needed, and how they integrate ketamine therapy with other ongoing treatments like medication management or psychotherapy. Evidence suggests that combining ketamine with psychological therapy may extend therapeutic benefits, so ask whether your provider offers or recommends concurrent psychotherapy (Walsh et al., 2022).
Question 4: “What Are the Potential Risks and Side Effects, and How Do You Manage Them?”
Every medical treatment carries potential risks, and ketamine therapy is no exception. This question demonstrates that you’re approaching treatment thoughtfully and gives your provider opportunity to discuss safety monitoring and risk management strategies.
Common side effects during ketamine administration include the dissociative effects mentioned earlier, as well as temporary increases in blood pressure and heart rate, nausea, dizziness, and headache. Most side effects resolve quickly after the infusion ends. Your provider should explain that they monitor vital signs throughout each session and have protocols for managing any concerning reactions. At Luvita, all ketamine infusions occur under medical supervision with continuous monitoring to ensure safety.
Ask also about longer-term considerations. Research on repeated ketamine use for psychiatric purposes continues to evolve, and your provider should acknowledge both what’s known and what remains uncertain. Topics like potential effects on cognition, bladder health with long-term use, and risk of psychological dependence deserve open discussion. Reputable providers will acknowledge these considerations honestly while explaining how their protocols minimize risks—for example, through careful patient screening, appropriate dosing, monitoring between sessions, and limiting treatment to the minimum effective frequency (Rosenblat et al., 2022).
Additionally, ask what happens if ketamine doesn’t work for you. Not everyone responds to ketamine therapy, and results vary by individual. Your provider should discuss what percentage of patients typically respond to treatment, how they define “response,” and what alternative options exist if ketamine proves ineffective in your case. This conversation helps you understand that ketamine represents one option among several for treatment-resistant depression, not a last resort.
Question 5: “What Can I Do to Maximize the Effectiveness of Ketamine Therapy?”
This question positions you as an active participant in your treatment rather than a passive recipient. Research consistently shows that patient engagement, preparation, and integration work significantly impact ketamine therapy outcomes (Grabski et al., 2020).
Your provider should discuss the importance of “set and setting”—meaning your mindset going into treatment and the environment where treatment occurs. Approaching ketamine sessions with openness, realistic expectations, and specific therapeutic intentions appears to enhance effectiveness. Some providers recommend specific preparation practices like identifying what you hope to work on during sessions, maintaining a journal to track experiences and insights, or engaging in stress-reduction practices between sessions.
Ask whether psychotherapy is recommended alongside ketamine treatment. Research suggests that combining ketamine with psychotherapy may extend antidepressant effects and help integrate any insights that arise during ketamine experiences into lasting psychological change (Walsh et al., 2022). At Luvita, our integrative approach includes intention-setting guidance before sessions and support for processing experiences afterward, recognizing that ketamine’s therapeutic potential is maximized when it’s part of a comprehensive treatment approach rather than an isolated intervention.
Additionally, inquire about lifestyle factors that might enhance or interfere with treatment effectiveness. This includes discussion of substance use (particularly alcohol, which you may need to avoid around treatment times), sleep patterns, nutrition, exercise, and stress management. Your provider should also explain any specific preparation needed before sessions, such as fasting requirements or medication adjustments.
Beyond These Five: Other Important Questions
While the five questions above form the essential foundation, other topics deserve discussion depending on your circumstances. These might include:
- How does your provider handle emergencies or concerning symptoms between appointments?
- What insurance do they accept, and what are the out-of-pocket costs?
- Do they offer payment plans for those with high deductibles?
- How do they coordinate care with your other healthcare providers?
- What telehealth options exist for follow-up appointments?
- Do they have experience treating patients with your specific co-occurring conditions?
For Montana residents, practical questions about travel, weather contingencies for winter appointments, and local accommodation recommendations if you’re coming from a distance may also be relevant.
Practical Steps You Can Take This Week
- Write Down Your Personal Treatment Goals
Before your consultation, spend time articulating what you actually hope to achieve with treatment. Be specific: rather than “feel better,” consider goals like “have energy to return to work,” “reduce suicidal thoughts,” “reconnect with family,” or “sleep through the night consistently.” These concrete goals help your provider understand what success looks like for you and allow for meaningful discussion about whether ketamine therapy can address your specific priorities. Research shows that realistic goal-setting and positive expectations promote better therapeutic alliance and treatment outcomes (Grabski et al., 2020).
- Prepare Your Questions Document
Type or write out these five questions plus any additional questions specific to your situation. Bring this document to your consultation, and don’t hesitate to refer to it during the appointment. It’s common to feel nervous or overwhelmed during medical appointments, especially when discussing vulnerable topics like mental health struggles. Having your questions written down ensures you address everything important even if you feel anxious in the moment. Leave space after each question to jot down notes on your provider’s answers.
- Arrange Transportation and Support
If you decide to move forward with ketamine therapy, you’ll need someone to drive you home after each session. Start identifying who in your life might be able to provide this support. This might be a family member, friend, or trusted community member. Having transportation arranged before you begin removes a practical barrier that could otherwise interfere with treatment. Additionally, consider whether you’d like someone to accompany you to your initial consultation for emotional support—many people find it helpful to have a trusted person present during these important conversations.
Moving Forward With Confidence
Coming prepared with thoughtful questions transforms your ketamine therapy consultation from a passive information session into an empowering conversation about your care. You deserve to understand fully what treatment involves, what you can realistically expect, and how to maximize your chances of positive outcomes. Results vary by individual, and ketamine therapy doesn’t work for everyone, but approaching treatment as an informed, engaged participant gives you the best possible foundation for success.
At Luvita, we believe in thorough consultation where all your questions receive honest, evidence-based answers. Our person-centered approach means we take time to explain our methodology, address your concerns, and help you decide whether ketamine therapy aligns with your treatment goals and personal circumstances. We offer free 15-minute discovery calls where you can ask preliminary questions and determine whether to schedule a full consultation.
To begin the conversation about ketamine therapy for treatment-resistant depression, call Luvita at (406) 443-7871 or schedule online at luvita.us. We serve patients throughout Montana, Wyoming, and Colorado with both in-person appointments at our Helena location and telehealth options for follow-up care. Your questions matter, and we’re here to answer them.
References
Grabski, M., Borissova, A., Marsh, B., et al. (2020). Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. Frontiers in Psychiatry, 13, 868103. https://pmc.ncbi.nlm.nih.gov/articles/PMC9207256/
Rosenblat, J.D., Leon-Carlyle, M., & McIntyre, R.S. (2022). Mapping consent practices for outpatient psychiatric use of ketamine. Journal of Clinical Psychiatry, 83(5), 22m14390. https://pubmed.ncbi.nlm.nih.gov/35753499/
Walsh, Z., Mollaahmetoglu, O.M., Rootman, J., et al. (2022). Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review. BJPsych Open, 8(1), e19. https://pmc.ncbi.nlm.nih.gov/articles/PMC8715255/
