Essential Documents and Information to Bring
Arriving at your consultation with organized medical information streamlines the evaluation process and ensures your provider has complete context for making treatment recommendations. Scrambling to remember medication names or approximating when you tried different treatments reduces the accuracy of assessment and potentially delays starting treatment if key information is missing.
Bring a complete list of all psychiatric medications you’ve tried for depression, including specific medication names, doses, duration of each trial, and why you stopped. “I tried Zoloft but I don’t remember the dose or how long I took it” provides less useful information than “sertraline 100mg daily for 12 weeks, discontinued due to sexual side effects without mood improvement.” The more specific your medication history, the better your provider can assess whether you truly have treatment-resistant depression versus inadequate trials of potentially effective medications.
Current medication list should include everything you take regularly—prescription psychiatric medications, other prescription drugs for medical conditions, over-the-counter supplements, vitamins, and herbal products. Some medications interact with ketamine or affect treatment decisions. For instance, certain blood pressure medications, stimulants, or supplements like St. John’s Wort influence ketamine safety or efficacy. Don’t assume your provider knows what you’re taking—bring a written list or photos of your medication bottles.
Medical records from previous psychiatric treatment help verify your treatment history and provide context your verbal history might miss. If you’ve seen multiple providers or changed insurance several times, tracking down every record isn’t realistic. However, recent records from your current psychiatrist or therapist, documentation of previous medication trials, or hospital records from psychiatric hospitalizations all provide valuable information. Many electronic health systems allow you to download summary records yourself, making this easier than requesting official records transfers.
Insurance information including your insurance card, policy details, and any prior authorization documentation affects practical aspects of treatment. If you’re considering SPRAVATO® which requires insurance coverage, bring your insurance card so the clinic can verify benefits during your consultation. For IV ketamine therapy which is typically private pay, understanding your out-of-pocket costs upfront helps you make informed financial decisions about treatment.
Medical History Your Provider Needs to Know
Certain medical conditions affect ketamine therapy safety or appropriateness. Discussing these honestly during your consultation prevents complications and ensures ketamine is medically suitable for you specifically.
Cardiovascular history matters significantly for ketamine therapy. Uncontrolled high blood pressure, history of heart attack or stroke, aneurysms, or significant cardiovascular disease require careful evaluation before ketamine treatment. Ketamine temporarily increases blood pressure during administration, which is manageable for most people but potentially dangerous for those with severe cardiovascular problems. If you have cardiovascular conditions, bring documentation of recent blood pressure readings, cardiac testing results, or cardiologist notes.
Substance use history requires honest disclosure even though discussing past or current drug use feels uncomfortable. Ketamine has abuse potential, and providers need to assess whether your substance use history makes ketamine therapy inappropriate or requires special precautions. This doesn’t mean any substance use history disqualifies you—many people with past substance use disorders safely pursue ketamine therapy. But active untreated substance use disorders, particularly involving ketamine or related substances, may preclude treatment until the substance use is addressed.
Mental health history beyond depression affects treatment planning. History of psychosis or schizophrenia typically contraindicates ketamine therapy because dissociative effects might trigger psychotic symptoms. Severe anxiety disorders require discussion about how dissociation might affect you—some people with anxiety find dissociative experiences distressing despite psychiatric benefits. Bipolar disorder requires careful consideration because rapidly-acting antidepressants can potentially trigger manic episodes.
Other medical conditions like thyroid disorders, sleep apnea, or chronic pain influence both treatment decisions and expected outcomes. Sleep apnea affects how safely you tolerate sedation during treatment. Thyroid problems can worsen depression and should be optimized before attributing treatment resistance to inadequate antidepressant trials. Chronic pain changes ketamine dosing considerations and treatment goals since ketamine addresses both pain and depression.
The board-certified emergency medicine physicians at Allevate Health have 18+ years of experience evaluating complex medical histories and determining when ketamine therapy is appropriate despite complicating factors versus when medical conditions make alternative treatments safer. Their emergency medicine background means they’re skilled at cardiovascular assessment and understanding how medical comorbidities affect treatment safety.
Questions About Treatment Process and Expectations
Understanding what ketamine therapy actually involves—the logistics, timeline, and realistic expectations—helps you decide whether pursuing treatment fits your life circumstances and aligns with your goals.
Ask what the actual treatment schedule looks like in practical terms. How many treatments per week initially? How long does each session take from arrival to departure? What’s the recommended total number of treatments in the initial series? These logistical details determine whether you can realistically commit to treatment given work schedules, childcare responsibilities, transportation availability, or other life demands. Ketamine therapy requiring six sessions over 2-3 weeks with two-hour observation periods poses different logistics challenges than monthly treatments.
Question what happens during treatment itself so you know what to expect physically and experientially. How is ketamine administered—IV infusion or nasal spray? What does dissociation feel like, and how intense will it be? What monitoring happens during treatment? Will you be in a private room or shared space? Understanding the actual treatment experience reduces anxiety about the unknown and helps you mentally prepare for potentially unusual perceptual changes. Our post on what it feels like to get a ketamine infusion offers a patient-perspective account of the experience that may help you prepare.
Ask about timeline for expected improvement. Research on ketamine’s rapid antidepressant effects shows many people notice changes within hours to days after treatment, but the pattern varies considerably (Wilkinson et al., 2017). Some people experience dramatic lifting of depression after the first session. Others need several treatments before noticing improvement. Still others have minimal response despite adequate trials. Realistic expectations prevent either premature discouragement if you don’t feel instantly better or unrealistic hope that one treatment will permanently cure treatment-resistant depression.
Inquire about what happens after the initial treatment series. Do most patients need maintenance treatments, or does improvement persist after the initial series ends? How frequently do maintenance treatments typically occur? What’s the plan if symptoms return between treatments? Understanding the long-term treatment commitment helps you assess whether ketamine therapy fits your life sustainably rather than just addressing immediate crisis. For more detail on treatment duration and ongoing effects, our article on how long ketamine treatment takes to work walks through timelines and response patterns.
Questions About Safety and Side Effects
Safety concerns represent legitimate barriers to pursuing ketamine therapy, particularly for people who’ve had negative experiences with other medications or feel anxious about novel treatments. Asking direct questions about safety protocols and potential side effects helps you make informed risk-benefit assessments.
Ask specifically about safety monitoring during treatment. What vital signs are monitored and how frequently? What emergency equipment is available if complications occur? Who’s present during treatment—physicians, nurses, medical assistants? What training do staff have in managing emergencies? These questions aren’t insulting to competent providers—they’re responsible due diligence ensuring the clinic takes safety seriously. According to guidelines from the American Psychiatric Association, patients should inquire about monitoring protocols, emergency preparedness, and staff qualifications when considering ketamine therapy (APA, 2022).
Question what side effects to expect and which require medical attention. Dissociation, nausea, blood pressure changes, and sedation are common during treatment. But which side effects are normal versus concerning? When should you contact the clinic between treatments? What symptoms warrant emergency care? Clear guidance about distinguishing expected side effects from serious problems prevents both unnecessary anxiety about normal effects and dangerous minimization of genuinely concerning symptoms.
Ask about contraindications and risk factors specific to your medical history. If you have high blood pressure, how is that managed during treatment? If you’ve had psychotic symptoms previously, does that completely rule out ketamine or just require extra caution? If you take multiple medications, are there interaction concerns? Providers should give specific answers based on your individual situation rather than generic reassurances that everything will be fine.
Discuss what disqualifies people from ketamine therapy so you understand whether you’re truly a good candidate or whether providers are minimizing concerns to get another patient. Reputable clinics turn away people for whom ketamine poses unacceptable risks. If a provider has never declined to treat anyone regardless of medical complexity, that suggests inadequate screening rather than exceptional expertise.
Questions About Costs and Insurance
Financial considerations affect treatment accessibility and require clear discussion before starting rather than discovering unexpected costs after you’re committed to treatment.
Ask directly about total costs—per session pricing, typical number of sessions needed, and any additional fees beyond the treatment itself. At Allevate Health, IV ketamine therapy costs $600 per session with initial series typically involving six treatments over 2-4 weeks (total ~$3,600). Understanding complete costs upfront prevents surprises and allows realistic financial planning. Some clinics advertise low per-session costs but require more total sessions or charge separately for consultation, monitoring, or other services. You can review Allevate Health’s full fee structure and financing options on our pricing page.
Question what’s included in the session fee. Does it cover pre-treatment medical evaluation, the medication itself, medical supervision during treatment, monitoring equipment use, and post-treatment observation? Or do additional charges apply for some of these components? Comprehensive per-session fees simplify budgeting compared to itemized charges for individual services.
For SPRAVATO® treatment, ask about insurance coverage specifics. Is the clinic in-network with your insurance? What does prior authorization involve, and how long does it typically take? What will your out-of-pocket costs be—copays, deductibles, or coinsurance? Will the clinic handle insurance billing directly, or do you pay upfront and seek reimbursement? Insurance coverage makes SPRAVATO® financially accessible, but understanding your specific coverage details prevents confusion about costs.
Inquire about payment options and financing if paying out of pocket. Does the clinic offer payment plans? Work with medical financing companies? Require full payment upfront or allow payment per session? Allevate Health partners with Advanced Care to offer financing options, making treatment accessible even when paying the full initial series cost upfront isn’t feasible. Understanding payment flexibility helps you proceed with treatment rather than delaying indefinitely while saving money.
Questions About Treatment Efficacy and Alternatives
Making informed decisions requires understanding not just what ketamine therapy offers but how it compares to alternatives and what happens if it doesn’t work for you.
Ask about success rates and what defines success. What percentage of patients experience significant improvement? How is improvement measured—complete remission of symptoms or meaningful reduction in symptom severity? Research on ketamine and esketamine shows response rates around 70% for treatment-resistant depression, but individual results vary (Zarate et al., 2012). Understanding realistic success rates helps calibrate expectations while recognizing that meaningful benefit is possible even if complete cure isn’t guaranteed.
Question how long benefits typically last after ketamine treatment. Do antidepressant effects persist between treatments, or do they fade within days requiring frequent ongoing sessions? Research suggests ketamine’s initial effects may last days to weeks, with maintenance treatments extending benefit. But duration varies considerably between individuals. Understanding typical benefit duration helps you assess whether the treatment schedule fits your life and whether the relief duration justifies the time and cost investment.
Ask what happens if ketamine therapy doesn’t work for you. What alternative treatments remain? Will the provider help you access those alternatives or refer you elsewhere? Does inadequate ketamine response provide information guiding next treatment choices? Good providers don’t present ketamine as your last hope—they position it as one tool among several for treatment-resistant depression, with other options remaining if ketamine doesn’t prove effective.
Discuss how ketamine therapy integrates with your other treatments. Should you continue current antidepressant medications during ketamine therapy or taper off? Does your therapist need to coordinate with the ketamine provider? Can you pursue ketamine therapy and psychotherapy simultaneously? Integrated treatment typically produces better outcomes than isolated interventions, so understanding how ketamine fits into your overall treatment plan matters.
What to Expect During the Consultation Itself
Understanding consultation structure helps you use the appointment time effectively rather than leaving with unaddressed questions or concerns. For a detailed preview of how Allevate Health structures the patient intake and consultation process, the What to Expect page provides a full walkthrough.
The consultation typically begins with comprehensive review of your psychiatric history—when depression started, previous diagnoses, all treatments tried and their outcomes, current symptoms and their severity, impact on functioning, and what you hope to achieve with treatment. This review takes significant time, so allocating an hour for consultation isn’t excessive. Come prepared to discuss sensitive topics like suicidal thoughts, past psychiatric hospitalizations, or substance use—providers need complete information to make appropriate treatment recommendations.
Physical examination or vital sign measurement might occur during consultation. Baseline blood pressure measurement identifies pre-existing hypertension requiring management before ketamine treatment. Some providers check heart rate and perform brief cardiovascular assessment. This isn’t invasive examination but basic screening ensuring no obvious medical contraindications to ketamine therapy.
Discussion of your specific questions should happen during consultation, not after you’ve already decided to proceed. Bring written questions so you don’t forget to ask something important. Take notes on answers or ask if you can record the conversation for later reference. If the provider seems rushed or dismissive of questions, that’s concerning and suggests reconsideration about proceeding with treatment at that clinic.
Treatment recommendation concludes the consultation—the provider’s professional opinion about whether ketamine therapy is appropriate for you, which form (IV ketamine versus SPRAVATO®) best fits your situation, and what treatment schedule they recommend. This isn’t a high-pressure sales pitch for immediate commitment—it’s clinical judgment about medical appropriateness. Feel empowered to take time considering the recommendation, discussing with other providers or loved ones, and making deliberate decisions rather than feeling pressured to commit immediately.
Making Your Final Decision
After your consultation, you’re equipped to decide whether pursuing ketamine therapy makes sense for your specific situation. Several factors should influence your decision beyond just whether you qualify medically.
Consider whether you can commit to the treatment schedule. Initial series requiring multiple treatments weekly demands significant time investment. If work, family, or health circumstances make that commitment unrealistic currently, delaying treatment until life circumstances permit better adherence might be wiser than starting and stopping inconsistently.
Assess whether the safety protocols and provider expertise meet standards. Did your consultation inspire confidence in the provider’s qualifications and the clinic’s safety measures? Or did you leave with concerns about whether appropriate monitoring and emergency preparedness exist? Trust your instincts—if something feels concerning about the provider or facility, those concerns are valid even if you can’t articulate exactly what’s wrong.
Evaluate whether the cost fits your budget sustainably. Initial treatment series cost is substantial, but maintenance treatments may continue indefinitely. Can you afford both initial series and ongoing treatments if needed? If costs strain your finances severely, that stress might undermine treatment benefits. Consider whether other uses of those funds (intensive therapy, lifestyle changes, other medical treatments) might provide comparable benefit at lower cost.
Reflect on your readiness for potentially unusual experiences. Dissociation during ketamine therapy isn’t dangerous, but it represents unfamiliar altered consciousness that some people find intriguing while others find unsettling. If you’re extremely anxious about losing control or experiencing perceptual changes, discuss those concerns during consultation and consider whether the anxiety about treatment might outweigh potential benefits.
Coming prepared to your ketamine therapy consultation with organized medical information and thoughtful questions helps you make informed decisions about whether this treatment approach fits your needs. The consultation isn’t just an appointment to get through—it’s your opportunity to gather information, assess the provider and facility, and determine whether pursuing ketamine therapy makes sense for your treatment-resistant depression. If you’re ready to explore whether ketamine therapy or SPRAVATO® treatment might help your treatment-resistant depression, Allevate Health offers complimentary consultations where board-certified emergency medicine physicians review your complete history and discuss whether innovative treatments are appropriate for your situation. Call (640) 252-9785 to schedule your consultation and take the first step toward finding relief when traditional antidepressants haven’t worked.
FAQ Section
Q: Do I need a referral from my psychiatrist to schedule a ketamine consultation?
A: Requirements vary by clinic and insurance. For SPRAVATO® covered by insurance, some plans require psychiatric referral or documentation of treatment-resistant depression from your current provider. For private-pay IV ketamine therapy, most clinics don’t require referral and accept self-referrals. Contact the clinic directly to clarify their specific requirements before scheduling.
Q: Will I start treatment the same day as my consultation?
A: No. Consultation involves evaluation and discussion to determine whether ketamine therapy is appropriate. If both you and the provider agree to proceed, treatment is typically scheduled for a separate appointment. This allows time for insurance authorization if needed, pre-treatment testing if indicated, and deliberate decision-making rather than pressured same-day commitment.
Q: Should I bring family members to the consultation?
A: Having a trusted person with you can help you remember information discussed and provide another perspective on treatment decisions. However, some people prefer privacy for discussing sensitive psychiatric history. Decide based on your comfort level—providers should accommodate either preference. If someone accompanies you, clarify whether they’ll be present throughout the consultation or just for final discussion and decision-making.
Q: What if I decide ketamine therapy isn’t right for me after the consultation?
A: Declining to proceed after consultation is completely appropriate. Consultation purpose is gathering information to make informed decisions, not committing to treatment. Good providers respect decisions to pursue alternative approaches or take time considering options rather than pushing immediate commitment. You’re not obligated to proceed just because you attended a consultation.
Q: How soon after consultation can I start treatment if I decide to proceed?
A: Timing depends on several factors. Private-pay IV ketamine therapy can often start within days if your schedule and the clinic’s availability align. SPRAVATO® requires insurance prior authorization which takes several days to weeks. Pre-treatment medical testing if needed adds additional time. Generally, expect one to three weeks between consultation and first treatment, though emergency situations might be accommodated faster.
References
American Psychiatric Association. (2022). Ketamine treatment for depression: What patients should know. https://www.psychiatry.org/patients-families
Wilkinson, S. T., Ballard, E. D., Bloch, M. H., Mathew, S. J., Murrough, J. W., Feder, A., Sos, P., Wang, G., Zarate, C. A., & Sanacora, G. (2017). The effect of a single dose of intravenous ketamine on suicidal ideation: A systematic review and individual participant data meta-analysis. American Journal of Psychiatry, 175(2), 150-158. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17040472
Zarate, C. A., Brutsche, N. E., Ibrahim, L., Franco-Chaves, J., Diazgranados, N., Cravchik, A., Selter, J., Marquardt, C. A., Liberty, V., & Luckenbaugh, D. A. (2012). Replication of ketamine’s antidepressant efficacy in bipolar depression: a randomized controlled add-on trial. Biological Psychiatry, 71(11), 939-946. https://pubmed.ncbi.nlm.nih.gov/22361653/