Not all ketamine clinics operate under the same standards — and for a treatment that involves continuous vital sign monitoring, individualized dosing, and management of dissociative side effects, the differences in provider qualifications and clinical protocols matter more than they might for other types of care. If you are considering IV ketamine therapy and trying to figure out what to look for, here is what we believe you deserve to know before you commit.
Why Provider Credentials Are the First Question
Ketamine is an anesthetic agent. It has been FDA-approved as such since 1970, and its safe administration at subanesthetic doses for psychiatric and pain conditions requires a provider who understands pharmacology, hemodynamics (how drugs affect blood pressure and cardiovascular function), and how to manage adverse effects. Before agreeing to treatment at any clinic, ask directly: who will be administering the infusion, and what are their clinical credentials?
At The Invictus Clinic, our two founding providers — Dr. Brandon Grinage, MD, an anesthesiologist, and Wesley Karcher, MSN, CRNA, a certified registered nurse anesthetist — are both anesthesia specialists. That is not a marketing distinction; it is the specific clinical background most directly relevant to IV ketamine administration. Dr. Grinage completed his anesthesiology residency at the Medical College of Georgia and has practiced in northwest Georgia since 2012. Wesley Karcher has practiced as a CRNA since 2007 and previously served as President of the Georgia Association of Nurse Anesthetists (GANA). Their combined decades of anesthesia experience inform every treatment decision we make, including dosing, monitoring protocols, and how we manage the transient dissociative effects that some patients experience during infusions. Read more about our team’s background and qualifications.
A 2022 peer-reviewed review of ketamine safety considerations found that prior to treatment, all patients should have a physical examination, vital signs assessment, and cardiorespiratory stability evaluation — and that screening for substance use history should be conducted, with toxicology screening considered in cases where substance misuse concerns are present (Kraus et al., 2022). Ask any clinic you are evaluating whether these steps are part of their standard intake process.
What a Thorough Intake Process Should Include
Before your first infusion, a reputable clinic should conduct a comprehensive evaluation that goes well beyond a brief intake form. This means a detailed review of your psychiatric and medical history, documentation of prior treatment trials (what medications you have taken, at what doses, and for how long), a full medication and allergy review including histories of opioid and benzodiazepine use, and a baseline symptom severity assessment to measure your starting point and track changes across treatment (Kraus et al., 2022).
You should also expect an honest conversation about whether you are an appropriate candidate. Certain medical and psychiatric conditions are contraindications to ketamine — meaning they significantly increase risk and may disqualify you from treatment. A history of active psychosis, certain cardiovascular conditions, and uncontrolled hypertension are among the factors a responsible provider will screen for before proceeding. If a clinic is willing to schedule your infusion after only a brief phone call with limited clinical review, that is a meaningful concern.
At The Invictus Clinic, your first appointment begins with a consultation with Dr. Grinage or Wesley Karcher. We review your full treatment history, discuss your goals, answer your questions, and spend as much time as necessary to understand your situation before making any recommendations. We do not rush the intake process because we do not believe that serves patients well. For additional guidance on what to expect, our post on navigating your first visit to a ketamine clinic walks through the process from the patient’s perspective.
Monitoring During and After Infusions
Ketamine’s side effect profile includes transient dissociative and psychotomimetic symptoms — temporary experiences of perceptual alteration, disconnection, or changes in thought that are dose-dependent and typically resolve within two hours of the infusion (Abdallah et al., 2022). In clinical trials, researchers use standardized tools like the Clinician-Administered Dissociative States Scale (CADSS) to assess these effects in real time. In a clinical practice setting, what matters is that a qualified provider is present throughout your infusion, monitoring you continuously.
A 2025 comprehensive review of ketamine safety identified continuous monitoring as a core element of responsible clinical administration, along with using the lowest effective dose and ensuring a calm, supervised environment throughout treatment (Moaddel et al., 2025). Ask specifically: will a provider be present in the room during my infusion, or will I be left alone? Will my blood pressure and heart rate be monitored throughout?
At The Invictus Clinic, we conduct comprehensive vital sign monitoring throughout every infusion. Our treatment rooms are private and comfortable, and our providers are present. You are also welcome to have one family member or trusted person stay with you during treatment — we have found that for many patients, that continuity matters.
Questions About Treatment Plans and Follow-Up
A responsible ketamine clinic treats infusion therapy as part of a broader care plan, not a standalone procedure. Ask about the recommended number of infusions and the rationale behind that recommendation based on your specific diagnosis and history. For mental health indications — including treatment-resistant depression, anxiety, PTSD, and OCD — infusions typically run 40–60 minutes. For chronic pain conditions, infusions may run up to four hours. The number of sessions in an initial series, and what follow-up looks like, should be discussed with you before treatment begins.
We also encourage patients to ask about the clinic’s relationship with their other providers. Ketamine therapy is not a replacement for psychotherapy or psychiatric care — it is most appropriately understood as part of a comprehensive treatment approach. We encourage patients to continue working with their mental health providers alongside any treatment at our clinic. To get a full picture of the range of treatments we offer, our services page is a good starting point.
Addressing the Cost and Scheduling Question
One of the most common barriers patients face is financial. IV ketamine for most psychiatric indications is not widely covered by insurance, and the out-of-pocket cost is real. At The Invictus Clinic, our per-treatment range is $400–$1,000. We offer a 15% discount for patients who pay upfront for their initial infusion series, and CareCredit financing is available for patients who need it. We accept Anthem Blue Cross Blue Shield, Aetna, and Medicare and will work with other insurers on coverage exploration.
SPRAVATO® (esketamine nasal spray), the FDA-approved treatment for treatment-resistant depression, is specifically noted as an insurance-accepted option at our clinic. SPRAVATO® requires concurrent use of an oral antidepressant and must be administered under medical supervision — both requirements that are built into how we offer it. For patients whose primary concern is cost, SPRAVATO® may be worth asking about specifically during the consultation. Individual results vary, and not every patient will be a candidate.
On scheduling: we are open Monday through Friday, 9AM–5PM, and offer Saturday appointments for patients whose work schedules make weekday visits difficult. We have structured our hours specifically to reduce the scheduling barrier that prevents some patients from accessing care.
A Note on Mail-Order and Telehealth-Only Ketamine
There has been growth in clinics offering compounded oral or sublingual ketamine with minimal in-person evaluation. The FDA issued a warning in 2023 about potential risks associated with compounded ketamine products used to treat depression and other psychiatric conditions. We cannot evaluate other providers, but we do believe patients should know that IV ketamine — the route with the strongest clinical evidence — requires in-person administration and real-time monitoring. Asking about the specific formulation and route of administration is a reasonable and important question.
Frequently Asked Questions
How do I know if I’m a candidate for IV ketamine?
Candidacy depends on your full medical and psychiatric history, prior treatment trials, and current medications. Contraindications exist for certain conditions, which is why a thorough evaluation comes first. The free consultation at our clinic is designed specifically to answer this question for your individual situation.
Should the provider administering my infusion be a physician?
Physician oversight and involvement in treatment planning are important, but certified registered nurse anesthetists (CRNAs) are qualified and licensed to administer ketamine in clinical settings. What matters most is the provider’s specific training in anesthetic agents and their clinical experience with ketamine administration. Ask about credentials and experience directly.
What should I bring to a first consultation?
It helps to arrive with a list of all current medications and dosages, a summary of prior psychiatric and medical treatments and how you responded, any relevant diagnostic history, and a list of questions. The more your provider knows about what you have already tried, the more useful the evaluation will be.
What happens if I have a side effect during the infusion?
Transient dissociative symptoms — temporary perceptual changes — are not uncommon during IV ketamine infusions and are dose-dependent. In clinical trials, these effects peak around 30–40 minutes into the infusion and resolve within two hours (Abdallah et al., 2022). Having a qualified provider present throughout is the appropriate safeguard. You should ask any clinic you are considering exactly who will be in the room with you and what their protocol is if you become uncomfortable.
Is the free consultation actually free?
Yes. Our consultation involves no financial commitment. It is a clinical evaluation designed to determine whether IV ketamine or another treatment at our clinic may be appropriate for you, and to answer your questions honestly.
Key Takeaways
- Provider credentials matter significantly for ketamine administration — ask specifically whether your infusions will be overseen and administered by clinicians with anesthesia training and what their monitoring protocols are.
- A thorough intake process should include a full psychiatric and medical history review, documentation of prior treatment trials, medication review, and baseline symptom assessment before any infusion is scheduled (Kraus et al., 2022).
- Continuous vital sign monitoring and qualified provider presence throughout the infusion are non-negotiable safety standards — not all clinics meet this bar equally.
- Cost is a real barrier; ask specifically about financing, series discounts, insurance acceptance, and whether SPRAVATO® — an FDA-approved, insurance-accepted option — may be appropriate for your situation.
- Ketamine therapy is most effective as part of a broader treatment plan; discuss how the clinic coordinates with your existing mental health providers before committing to a series.
Choosing a ketamine clinic is a medical decision, and you are entitled to ask hard questions before you commit. We built The Invictus Clinic around the belief that patients who have exhausted their options deserve both advanced treatment and complete transparency about what that treatment involves. Call us at 770-580-1042 or schedule your free consultation online — we are in Marietta, Georgia, open Monday through Friday, 9AM–5PM, and Saturdays by appointment.
References
Abdallah, C. G., Roache, J. D., Gueorguieva, R., Averill, L. A., Young-McCaughan, S., Shiroma, P. R., Purohit, P., Brundige, A., Murff, W., Ahn, K. H., Sherif, M. A., Baltutis, E. J., Ranganathan, M., D’Souza, D., Martini, B., Southwick, S. M., Petrakis, I. L., Burson, R. R., Guthmiller, K. B., Lopez-Roca, A. L., Lautenschlager, K. A., McCallin, J. P., Hoch, M. B., Timchenko, A., Souza, S. E., Bryant, C. E., Mintz, J., Litz, B. T., Williamson, D. E., Keane, T. M., Peterson, A. L., & Krystal, J. H. (2022). Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military. Neuropsychopharmacology, 47(8), 1574–1581. https://pmc.ncbi.nlm.nih.gov/articles/PMC9205895/
Kraus, C., Rabl, U., Vanicek, T., Carlberg, L., Popovic, A., Spies, M., Bartova, L., Gryglewski, G., Papageorgiou, K., Lanzenberger, R., Willeit, M., Winkler, D., Rybakowski, J. K., Walitza, S., Draganov, M., Rohracher, A., & Kasper, S. (2022). Ketamine treatment for depression: a review. Pharmacopsychiatry, 55(1), 10–21. https://pmc.ncbi.nlm.nih.gov/articles/PMC9010394/
Moaddel, R., Luckenbaugh, D. A., Manji, H. K., & Zarate, C. A. Jr. (2025). Safety considerations and risk mitigation strategies for ketamine use: a comprehensive review. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC12055169/
Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. IV ketamine therapy should only be pursued under the supervision of a licensed medical provider familiar with your full medical and psychiatric history. Ketamine is FDA-approved as an anesthetic; its use for psychiatric and pain conditions is off-label except where specified. SPRAVATO® (esketamine) is FDA-approved for treatment-resistant depression and requires administration under medical supervision with concurrent oral antidepressant use. Individual results vary. 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.
