Seven questions to vet any ketamine clinic before your first session

If you type 'ketamine clinic near me' into any search engine, you will get pages of results. The regulatory floor for opening a ketamine clinic is low - all that is strictly required is a licensed prescriber (usually a nurse practitioner or physician) with DEA registration. That means quality varies dramatically, from careful integrative practices to infusion mills with no screening and no aftercare.

These are the seven questions that will tell you which kind of clinic you are dealing with.

1. Who is in the room with me?

During your infusion you should be monitored continuously by someone with current BLS (basic life support) or ACLS (advanced cardiac life support) certification. Blood pressure, heart rate and oxygen saturation should be tracked. Good clinics have an RN or equivalent present for the entire session. Worrying clinics have you buzz a front desk if you need help.

2. Who is the prescriber and what are they board-certified in?

The prescriber should be board-certified in a specialty that maps to the indication - most commonly psychiatry for depression, anesthesiology for chronic pain, or emergency medicine. Nurse practitioners can absolutely run excellent clinics but should be supervised by or collaborating with a board-certified physician. ASKP3 (American Society of Ketamine Physicians, Psychotherapists and Practitioners) certification is a good additional signal.

3. What is the exact protocol?

A credible clinic can tell you the dose in mg/kg, the infusion duration, and the monitoring interval. IV ketamine for depression typically starts at 0.5 mg/kg over 40 minutes. Higher doses, shorter durations, or 'can you push it faster, I have to be back at work' attitudes are red flags.

4. Do you offer integration or therapy alongside the infusion?

The drug is the smaller part of the therapy. The clinics with the best long-term outcomes pair infusions with either their own psychotherapy or a partnership with outside therapists. A pure 'infusion only' model is a flag that the clinic has not kept up with current best-practice evidence.

5. What is your screening process?

You should be screened for active psychosis or mania, uncontrolled hypertension or cardiovascular disease, recent stroke, severe active substance use disorder and pregnancy. If a clinic is willing to infuse you after a five-minute phone call without reviewing medical records, that is a serious flag.

6. What is the price and does anything happen if it does not work?

Most clinics charge $400-$600 per IV session. A standard induction series is 6 sessions. Some clinics offer package pricing or a money-back guarantee after session 2 if the patient reports zero response - that is unusual but increasingly common.

7. How do you handle adverse events or emergencies?

The correct answer is: RN monitoring, crash cart, connection to a transport hospital, written escalation protocol, documented training for staff. You want to hear this without hesitation.

Red flags to walk away from

'Cure' or 'guaranteed outcome' language. No screening. No monitoring during the infusion. Prescriber you never meet or speak with. Pressure to prepay for a large package before your first session. Unwillingness to provide an itemized receipt (superbill) for HSA/FSA reimbursement.

Ketamine is a powerful and generally well-tolerated medicine. In the right hands it has changed lives. In the wrong hands it is dangerous and disappointing. Spend the 20 minutes on a consult - it is by far the highest-value due diligence you can do.