Ketamine Therapy for Depression: What to Know Before You Consider It
By Teresa Alasio, MD | Intentional Self Aesthetics, New Canaan, CT
Ketamine infusion therapy has emerged as one of the most significant breakthroughs in the treatment of depression in decades, particularly for patients who have not responded to conventional antidepressants. Here is what it is, how it works, and what makes it different from other approaches.
Why ketamine is different:
Traditional antidepressants work primarily on the serotonin, norepinephrine, or dopamine systems. They require weeks of consistent use before producing clinical effect, and they do not work for a significant portion of patients with major depressive disorder. Approximately one-third of patients with depression do not achieve adequate response after multiple medication trials.
Ketamine works through an entirely different mechanism: it acts on NMDA glutamate receptors and promotes rapid neuroplasticity, the brain’s ability to form new synaptic connections. This is why ketamine can produce measurable antidepressant effects within hours to days of the first infusion, rather than weeks. For patients who have suffered for years without adequate relief, this speed of response can be genuinely life-changing.
What the research shows:
Ketamine’s antidepressant effects are well-documented in peer-reviewed literature and have been replicated across multiple clinical trials. It is particularly effective for treatment-resistant depression (depression that has not responded to two or more antidepressant medications) and for patients experiencing suicidal ideation, where the rapid onset of effect is especially clinically meaningful.
How treatment works at Intentional Self Aesthetics:
Every patient undergoes a comprehensive medical and psychiatric evaluation before beginning ketamine therapy. Ketamine is not appropriate for everyone, and that evaluation is not a formality. During infusions, I am present throughout. Vital signs are monitored, the environment is designed for comfort and safety, and the dose and rate are managed precisely for each patient.
A standard ketamine protocol involves a series of infusions over two to three weeks, with response assessed at each stage. Maintenance infusions may follow depending on the patient’s response and clinical picture.
Ketamine and TMS:
Both ketamine and TMS offer non-traditional pathways for treating depression, and in some patients they are used in sequence or combination. The right approach depends on clinical presentation, prior treatment history, and the patient’s goals. This is a decision made in consultation, not by a checklist.
For more on TMS as a treatment for depression, see the related Ask Dr. Alasio post.
Ready to explore whether ketamine therapy is right for you? Request a consultation with Dr. Alasio.
Teresa Alasio, MD is a board-certified physician in Pathology, Cytopathology, and Aesthetics and the founder of Intentional Self Aesthetics at 23 Vitti Street, New Canaan, CT.
