Anxiety disorders are among the most common psychiatric conditions in the United States, and some people do not achieve adequate relief with first-line options such as SSRIs, SNRIs, and cognitive behavioral therapy (Bandelow et al., 2017; National Institute of Mental Health [NIMH], n.d.). At our clinic in Marietta, Georgia, we offer IV ketamine infusion therapy in Marietta, GA as an off-label option for patients with treatment-resistant anxiety who are seeking a clinically grounded alternative. If standard medications and therapy have not provided lasting relief, there may be a neurological reason for that and a different treatment pathway to explore.
The Neuroscience of Treatment-Resistant Anxiety
To understand why IV ketamine may help where other treatments have not, it helps to understand the neurochemistry underlying anxiety disorders. Most anxiety medications, including SSRIs, SNRIs, and benzodiazepines, act on serotonin, norepinephrine, or GABA pathways. These approaches help many patients, but they do not work for everyone (Bandelow et al., 2017).
Ketamine works through the glutamatergic system. Glutamate is the brain’s primary excitatory neurotransmitter, and NMDA receptors are one type of glutamate receptor. Research continues to examine how glutamate signaling may contribute to anxiety and how ketamine’s effects on this system may reduce symptoms for some patients (Tully et al., 2022).
In plain terms, this may be one reason the anxious brain can remain stuck in a heightened threat response even when conventional medications have not provided enough relief.
How IV Ketamine May Help Anxiety
Ketamine acts as an NMDA receptor antagonist. It temporarily blocks N-methyl-D-aspartate receptors, which are a key component of glutamatergic signaling. This action is associated with downstream changes involving AMPA receptors, BDNF, and synaptic plasticity, although the precise mechanisms responsible for ketamine’s effects on anxiety remain under study (Tully et al., 2022; Zanos & Gould, 2018).
Think of it this way: BDNF is often described as fertilizer for neural connections. It supports the growth and maintenance of synaptic pathways. Ketamine research has linked rapid changes in these neuroplasticity-related pathways with its distinct effects compared with medications that primarily target serotonin or norepinephrine (Zanos & Gould, 2018).
This mechanism can produce effects more quickly than standard antidepressants for some patients. While SSRIs and SNRIs may take weeks to become effective, ketamine’s anxiolytic effects can emerge within hours to days in some studies. Individual responses vary. Our discussion of how fast ketamine works for anxiety explains this in more detail.
Conditions we may evaluate for IV ketamine at our Marietta clinic include generalized anxiety disorder, social anxiety disorder, panic disorder, and OCD when these conditions have been formally diagnosed and prior treatment has not provided adequate relief. Results vary by individual, and not every patient with anxiety will respond to ketamine infusion therapy.
What the Research Shows
Clinical evidence for ketamine in anxiety disorders is still emerging. A small study of patients with treatment-refractory generalized anxiety disorder and social anxiety disorder found reduced anxiety within one hour after ketamine administration, with effects lasting up to seven days in some participants (Glue et al., 2017).
A randomized, placebo-controlled crossover trial in adults with social anxiety disorder found that a single IV ketamine infusion produced greater reductions in clinician-rated social anxiety symptoms than placebo over the two-week follow-up period (Taylor et al., 2018). A systematic review concluded that the evidence is preliminary and that larger, well-designed studies are still needed to clarify optimal dosing, duration, safety, and long-term outcomes for anxiety disorders (Tully et al., 2022).
We want to be clear: IV ketamine for anxiety disorders is used off-label. There is currently no FDA approval for IV ketamine specifically for anxiety conditions. SPRAVATO®, or esketamine nasal spray, is FDA-approved for treatment-resistant depression in adults and for depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behavior when used with an oral antidepressant. It is not approved for anxiety specifically (U.S. Food and Drug Administration [FDA], 2025). You can learn more about how these two options compare in our overview of SPRAVATO vs. Ketamine Therapy: Which Is Right for You?
Addressing Fear: What the Anxiety Patient Needs to Know About Ketamine
We recognize the particular irony here: patients who struggle with anxiety may feel apprehensive about entering an infusion experience that involves altered perception. This is a legitimate concern, and one we address directly.
At subanesthetic doses, ketamine may produce temporary dissociative or perceptual effects. Individual experiences vary. Before treatment begins, we discuss what the experience may feel like, what monitoring looks like, and what questions you may have before moving forward.
Before your first infusion, our clinical team will conduct a thorough intake that includes your mental health history, relevant treatment history, and a review of your medications. We will discuss what the experience is likely to feel like and answer every question you have. We will also discuss preparation strategies that are appropriate for your situation. For a detailed preview, see our guide on your first ketamine clinic visit.
Addressing Cost: IV Ketamine Pricing in Atlanta
IV ketamine infusions at our clinic are priced between $400 and $1,000 per session. We do not bill insurance directly for IV ketamine, although some insurers may provide out-of-network reimbursement depending on the plan. We offer a 15% discount when an infusion series is paid upfront and a 25% discount for active military personnel, veterans, and first responders. CareCredit is accepted for patients who prefer to finance treatment.
We encourage prospective patients to discuss their financial situation candidly during their consultation. Cost should not be the reason someone stops searching for relief.
The Treatment Protocol
An initial IV ketamine series often involves six infusions over two to three weeks. Infusions are approximately 40 minutes in duration, and a driver is required for every session. Many patients experience a cumulative effect across the series, and maintenance infusions may be scheduled based on response.
The specific protocol recommended for you will be determined by your provider during your intake evaluation. Results vary by individual.
Frequently Asked Questions
Can ketamine help generalized anxiety disorder?
Preliminary evidence suggests ketamine may reduce symptoms for some patients with treatment-refractory generalized anxiety disorder and social anxiety disorder. A small study found reduced anxiety within one hour after administration, with effects lasting up to seven days for some participants (Glue et al., 2017). Results vary by individual and are not guarantees of outcome.
Is IV ketamine for anxiety approved by the FDA?
No. IV ketamine for anxiety disorders is used off-label. SPRAVATO® is FDA-approved for specific depressive-disorder indications, not anxiety conditions (FDA, 2025).
I have OCD. Could ketamine help?
Preliminary evidence suggests ketamine’s glutamatergic mechanism may be relevant to OCD. In a small randomized crossover trial, participants who received IV ketamine showed reductions in obsessive symptoms compared with placebo, but the evidence base remains limited and further study is needed (Rodriguez et al., 2013). A careful clinical evaluation is required before determining candidacy. You may also find our post on how to challenge OCD compulsions a useful starting point for understanding OCD treatment approaches.
What if my anxiety worsens during the infusion?
Some patients may experience heightened anxiety or discomfort during the dissociative period of an infusion. Please disclose any history of panic attacks or dissociation-related distress during your consultation so your provider can discuss appropriate preparation and safety considerations.
How long do the effects of ketamine last for anxiety?
Response duration varies. Some patients experience weeks to months of meaningful anxiety reduction after a series, while others benefit from periodic maintenance infusions. There is currently no reliable way to predict duration of response in advance. Results vary by individual.
You can learn what to look for in a ketamine clinic before scheduling your first visit.
Key Takeaways
- Treatment-resistant anxiety may involve pathways not fully addressed by standard medications targeting serotonin, norepinephrine, or GABA.
- IV ketamine’s NMDA receptor antagonism is associated with downstream neuroplasticity-related changes involving AMPA signaling and BDNF (Zanos & Gould, 2018).
- IV ketamine for anxiety is used off-label. Early studies show possible rapid symptom reduction for some patients, but larger trials are still needed (Tully et al., 2022).
- Infusions are priced from $400 to $1,000 per session. We offer a 15% upfront series discount, a 25% military, veteran, and first-responder discount, and CareCredit financing.
- A thorough intake evaluation is required, and we guide patients carefully through infusion preparation and expectations.
Anxiety does not have to dictate your life. At our clinic in Marietta, GA, we take time to understand your history and work with you to build a treatment plan grounded in clinical evidence. Call us at 770-580-1042 or schedule a consultation to discuss whether IV ketamine therapy may be appropriate for you.
References
Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in Clinical Neuroscience, 19(2), 93-107. DOI: https://doi.org/10.31887/DCNS.2017.19.2/bbandelow
Glue, P., Medlicott, N. J., Harland, S., Neehoff, S., Anderson-Fahey, B., Le Nedelec, M., Gray, A., & McNaughton, N. (2017). Ketamine’s dose-related effects on anxiety symptoms in patients with treatment-refractory anxiety disorders. Journal of Psychopharmacology, 31(10), 1302-1309. DOI: 10.1177/0269881117705089. https://pubmed.ncbi.nlm.nih.gov/28441895/
National Institute of Mental Health. (n.d.). Any anxiety disorder. National Institutes of Health. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
Rodriguez, C. I., Kegeles, L. S., Levinson, A., Feng, T., Marcus, S. M., Vermes, D., Flood, P., & Simpson, H. B. (2013). Randomized controlled crossover trial of ketamine in obsessive-compulsive disorder: Proof-of-concept. Neuropsychopharmacology, 38(12), 2475-2483. DOI: 10.1038/npp.2013.150. https://pubmed.ncbi.nlm.nih.gov/23783065/
Taylor, J. H., Landeros-Weisenberger, A., Coughlin, C., Mulqueen, J., Johnson, J. A., Gabriel, D., Reed, M. O., Jakubovski, E., & Bloch, M. H. (2018). Ketamine for social anxiety disorder: A randomized, placebo-controlled crossover trial. Neuropsychopharmacology, 43(2), 325-333. DOI: 10.1038/npp.2017.194. https://pubmed.ncbi.nlm.nih.gov/28849779/
Tully, J. L., Dahlén, A. D., Haggarty, C. J., Schiöth, H. B., & Brooks, S. (2022). Ketamine treatment for refractory anxiety: A systematic review. British Journal of Clinical Pharmacology, 88(10), 4412-4426. DOI: 10.1111/bcp.15374. https://pubmed.ncbi.nlm.nih.gov/35510346/
U.S. Food and Drug Administration. (2025). SPRAVATO® (esketamine) nasal spray: Prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/211243s016lbl.pdf
Zanos, P., & Gould, T. D. (2018). Mechanisms of ketamine action as an antidepressant. Molecular Psychiatry, 23(4), 801-811. DOI: 10.1038/mp.2017.255. https://pubmed.ncbi.nlm.nih.gov/29532791/
Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Treatment for PTSD, depression, anxiety, and trauma-related conditions, including IV ketamine infusion therapy and SPRAVATO®, should only be pursued under the supervision of a licensed provider familiar with your full medical and psychiatric history. Individual results vary. SPRAVATO® is FDA-approved for specific indications; IV ketamine for psychiatric conditions is used off-label. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide & Crisis Lifeline or go to your nearest emergency room.
