More Richmond-area residents are researching ketamine therapy than ever before — and more of them are arriving at their first consultation without a clear picture of what the process actually involves. At InfuseRVA Ketamine & Wellness in South Chesterfield, we have structured our approach specifically to make that first step as straightforward as possible, because the patients who need this treatment most have often spent years trying to find something that works.
Who Ketamine Therapy Is Designed For
Ketamine infusion therapy is not a first-line treatment. A comprehensive systematic review published in Frontiers in Psychiatry confirms that IV ketamine should be considered after standard treatments have failed — specifically after a patient has not achieved sustained improvement following adequate antidepressant trials, different medication combinations, and in some cases other interventional approaches (Frye et al., 2023). In clinical practice, the threshold most commonly applied is the absence of adequate response to at least two antidepressant trials at therapeutic doses and for a sufficient duration.
This means the patients we work with at InfuseRVA are typically people who have already done the work. They have tried SSRIs, SNRIs, or other medication classes. They have likely been in therapy. They have not given up — but the treatments available to them through conventional care have not provided the relief they need. If that describes where you are, ketamine infusion therapy may be worth a serious conversation.
The conditions we treat include treatment-resistant depression, anxiety, PTSD, bipolar disorder, OCD, chronic pain, and suicidal ideation. Each patient we see is evaluated individually by our medical team before any treatment begins. That evaluation looks at your full history — diagnoses, prior treatments, medications you are currently taking, any adverse reactions you have experienced, and any medical conditions that could affect your candidacy for ketamine.
Certain factors may make someone a less suitable candidate: active psychotic symptoms, uncontrolled high blood pressure, specific cardiovascular conditions, or a history of substance use disorder all require careful consideration on a case-by-case basis. We discuss contraindications plainly during the evaluation, and we do not proceed with treatment unless we are confident it is appropriate. A large-scale systematic review of IV ketamine for major depressive disorder found the treatment to be safe and well-tolerated at sub-anesthetic doses in non-psychotic patients, while confirming that careful patient selection remains essential (Niciu et al., 2014).
What the Treatment Process Looks Like
Our standard course of IV ketamine infusion therapy involves a series of six infusions, each lasting approximately 40 to 60 minutes. Infusions are typically scheduled over a two- to three-week period during the induction phase. During each infusion, you will recline in a comfortable setting while the medication is administered through an IV line. Vital signs — blood pressure, heart rate, oxygen saturation, and respiratory rate — are monitored throughout.
Ketamine produces a dissociative state during the infusion itself. Patients describe this experience in different ways: some report a dreamlike quality, a sense of distance from their usual thought patterns, or mild perceptual shifts. These effects are temporary and resolve as the medication clears your system. Most patients feel grounded and clear-headed within an hour after an infusion ends. Side effects can include nausea, temporary headache, and fatigue following treatment; our team is prepared to manage these as needed. If you want to know more about the recovery phase, our post on what to expect after a ketamine infusion covers it in detail.
Because ketamine affects cognition and coordination for a period after infusion, you cannot drive yourself home. We require that every patient have a confirmed adult driver before we begin any infusion. We also advise against strenuous physical activity, operating machinery, watching small children, and entering into legal contracts for 24 hours following treatment. These are not optional precautions — they are requirements that protect your safety.
For patients who also want to integrate therapeutic work into their treatment, we offer ketamine-assisted psychotherapy. Research consistently shows that combining ketamine with psychotherapy may improve outcomes and support longer-term stability by using the neuroplastic window that ketamine may open as an opportunity to reinforce adaptive thought patterns. We do not require that patients be in therapy, but we strongly encourage it.
For patients who qualify, we also offer SPRAVATO® treatment. SPRAVATO® is an FDA-approved nasal spray form of esketamine indicated specifically for treatment-resistant depression and for major depressive disorder with acute suicidal ideation or behavior. It is administered in our office, and patients must be directly observed for at least two hours after each dose. SPRAVATO® follows a different protocol from IV ketamine and is subject to a Risk Evaluation and Mitigation Strategy (REMS) program; the right fit between IV ketamine and SPRAVATO® depends on each patient’s clinical profile and individual goals.
What to Bring and What to Expect Before Your First Visit
No referral is required to reach out to us. That said, the more information you bring to your initial consultation, the more useful that conversation will be. We ask patients to gather documentation of their diagnoses, the full history of their past treatments (including medication names, doses, and duration), any adverse reactions they have experienced, and a current medication list. If you have records from previous psychiatric evaluations or hospital visits, those can also be helpful.
We also recommend that you let your current physician or therapist know you are exploring ketamine therapy before your first infusion. Not because it is required, but because treatment that proceeds in communication with your existing care team tends to be better coordinated and more effective over time. Ketamine is not a replacement for ongoing mental health care — it is, for many patients, a meaningful addition to it. Our ketamine infusion FAQs page addresses many of the common questions patients bring to that first conversation.
How InfuseRVA Approaches Your Care
We are located at 16021 Kairos Rd., Suite A in South Chesterfield — accessible to patients throughout the Richmond metro area, including Chester, Mechanicsville, Powhatan, and surrounding communities. Our hours are Monday through Friday, 9:00 AM to 5:00 PM.
What distinguishes our approach is the emphasis we place on evaluation before we recommend anything. Every patient who begins ketamine treatment at our clinic has been assessed by our medical director or another licensed physician. We do not treat ketamine therapy as a product to be sold — we treat it as a clinical decision that requires the same seriousness as any other medical intervention. Results vary by individual, and we discuss what that means honestly with every patient we see.
Frequently Asked Questions
Do I need a psychiatrist’s referral to receive ketamine therapy at InfuseRVA? No referral is required. We ask that you bring documentation of your diagnoses, past treatments, current medications, and any adverse reactions to prior treatments. We do recommend informing your physician or therapist about your plans before beginning treatment.
How do I know if I have tried enough medications to qualify? The clinical standard most commonly applied is inadequate response to at least two antidepressant medications at appropriate doses for an appropriate duration. If you are uncertain whether your history meets that standard, our evaluation process will help clarify that. Some patients who have been told they are treatment-resistant have actually never completed a full therapeutic trial — and for others, the history makes their status clear.
Can I receive ketamine therapy if I am currently taking antidepressants? In many cases, yes. Whether to continue, taper, or adjust current medications is a decision made based on your specific medication profile, your history, and your clinical situation. We review all current medications as part of the pre-treatment evaluation and discuss any interactions or adjustments that may be relevant.
What is the difference between IV ketamine and SPRAVATO®? IV ketamine is administered intravenously in a series of infusions. SPRAVATO® is an FDA-approved nasal spray form of esketamine indicated specifically for treatment-resistant depression and for major depressive disorder with acute suicidal ideation or behavior. The two treatments work through related but distinct mechanisms and follow different protocols. We can help you think through which may be more appropriate during your evaluation.
What if ketamine does not work for me? Not all patients respond to ketamine, and we discuss that possibility honestly from the start. If you complete a course of treatment without meaningful benefit, we will have a candid conversation about what that means and what options may remain. We do not recommend continuing treatment that is not producing results, and we will never suggest otherwise.
Key Takeaways
- IV ketamine infusion therapy is intended for patients with treatment-resistant conditions who have not found adequate relief through conventional treatments — not as a first-line option.
- A thorough pre-treatment evaluation by a licensed physician is required before treatment begins at InfuseRVA; contraindications are assessed individually.
- The standard induction course involves six infusions; patients must have a confirmed driver for every appointment and observe post-infusion activity restrictions for 24 hours.
- No referral is required to reach out to InfuseRVA, and patients can schedule a consultation to discuss whether ketamine therapy may be appropriate for their situation.
If you are in the Richmond area and have been living with depression, anxiety, PTSD, or another treatment-resistant condition, we want to hear from you. Call InfuseRVA at804-895-4636 or schedule a consultation through our website — we will give you a straight answer about whether this treatment makes sense for your situation, and we will not recommend it if it does not.
References
Frye, M.A., Blier, P., & Tye, S.J. (2023). Use of ketamine for treatment resistant depression: Updated review of literature and practical applications to a community ketamine program in Edmonton, Alberta, Canada. Frontiers in Psychiatry, 14, 1283733. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1283733/full
Niciu, M.J., Luckenbaugh, D.A., Ionescu, D.F., Mathews, D.C., Richards, E.M., & Zarate, C.A. (2014). The role of ketamine in treatment-resistant depression: A systematic review. CNS Spectrums, 19(1), 1–12. https://pmc.ncbi.nlm.nih.gov/articles/PMC4243034/
Rodrigues, N.B., McIntyre, R.S., Lipsitz, O., Cha, D.S., Lee, Y., Rosenblat, J.D., & Mansur, R.B. (2022). Neurocognitive effects of repeated ketamine infusion treatments in patients with treatment-resistant depression: A retrospective chart review. BMC Psychiatry, 22, 137. https://link.springer.com/article/10.1186/s12888-022-03789-3
Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. IV ketamine infusion therapy and SPRAVATO® treatment should only be pursued under the supervision of a licensed medical professional familiar with your complete medical and psychiatric history. Individual results vary. Not all patients are candidates for ketamine therapy. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.
