Pain Management Procedures

Ketamine Infusion Therapy

When pain keeps getting in the way, it may be time to explore a different approach.

You’ve tried treatments. You’ve followed recommendations. But pain is still affecting your days—and perhaps your sleep, your independence, and the activities you miss most.

For some people with difficult-to-treat chronic pain, ketamine infusion therapy offers another option worth discussing.

At Associated Physicians Group, the first step is a consultation with our pain management team. Dr. Hamed Sadeghipour can review your symptoms, previous treatments, and overall health to determine whether ketamine belongs in your treatment plan.

You don’t need to know whether ketamine is right for you before you call. That’s what the consultation is for.

What is ketamine infusion therapy?

Ketamine is a medication used in anesthesia that can also be given at lower doses to treat certain difficult-to-manage conditions. During an infusion, medication is delivered gradually through a small IV.

Ketamine works differently from opioid pain medications. It affects receptors involved in how the nervous system processes pain.

When pain persists, the nervous system can become unusually sensitive—almost as though its pain “volume” has been turned up. Ketamine may help reduce this amplified signaling in some patients. It does not repair an underlying injury, but it may provide relief when other approaches have not been enough.

Who might benefit?

Ketamine may be considered for selected patients with complex regional pain syndrome, or CRPS, and certain persistent nerve-pain conditions that have not responded adequately to other treatments.

For some patients with CRPS, studies have shown meaningful pain relief lasting several weeks. Other nerve-pain conditions may also respond, although results are less predictable.

Your diagnosis is only part of the decision. Your previous treatment response, medical history, and personal goals also matter. The consultation helps answer a more useful question than “Does ketamine work?”:

“Is there a reasonable chance it could help someone with my situation?”

What could meaningful improvement look like?

The goal is more than changing a number on a pain scale.

Before treatment, discuss what you most want to accomplish: tolerating physical therapy, walking farther, sleeping with fewer interruptions, or participating more comfortably in everyday activities.

These are treatment goals—not guaranteed outcomes. Tracking them alongside your pain helps determine whether an infusion provides enough benefit to justify continuing.

Ketamine is generally one part of a broader plan, not a replacement for rehabilitation or other appropriate care.

What about ketamine for depression?

Ketamine has also been studied extensively for treatment-resistant depression—depression that has not improved adequately after appropriate trials of antidepressant medication.

Some patients experience improvement within hours or days, rather than the weeks often needed for conventional antidepressants. Not everyone responds, and initial improvement may fade, so follow-up care and a longer-term plan remain important.

If depression is part of what you are experiencing, tell your care team. Evaluating ketamine for depression requires a mental-health assessment and coordination with the clinician managing your psychiatric care. A pain-treatment infusion should not automatically be assumed to provide an appropriate depression-treatment plan.

What happens before, during, and after treatment?

Before: a conversation and an individualized plan

Your evaluation includes your symptoms, medical history, medications, previous treatments, and questions. Discuss heart or blood-pressure problems, liver disease, pregnancy, mental-health history, and any history of substance misuse.

If treatment is appropriate, your clinician will explain the proposed infusion schedule, monitoring, recovery requirements, and how your response will be evaluated. There is no single schedule that fits every patient.

During: medication delivered gradually, with monitoring

A small IV delivers the medication while your clinical team monitors your condition and response. Monitoring includes blood pressure, heart rate, breathing, and oxygen levels.

You may feel sleepy, lightheaded, or temporarily disconnected from your surroundings. Some people describe a floating or dreamlike sensation. These experiences can feel unfamiliar; tell the team if you feel uncomfortable or anxious.

After: recovery and follow-up

You will need time to recover before leaving. Arrange for someone to drive you home, and follow your team’s instructions about driving, work, medications, and other activities.

Follow-up is important even if you feel better quickly. Your response helps guide whether additional treatment makes sense.

Questions patients often ask

How soon might I notice a difference?

The timing and duration of relief vary. Some patients notice an early change; others may need their response assessed over a planned course. Some do not experience meaningful improvement.

How many infusions will I need?

That depends on the condition being treated, your response, and how well you tolerate treatment. Ask about the initial plan and the criteria for continuing before starting.

Is ketamine FDA-approved?

Ketamine is FDA-approved as an anesthetic. Its use for chronic pain and depression is off-label, meaning it is prescribed for a purpose outside that approval.

Off-label does not mean there is no supporting research. It does mean the potential benefits and risks need to be considered for your specific condition. Esketamine nasal spray is a different medication with FDA-approved depression indications; it is not interchangeable with IV ketamine.

What risks should I understand?

Possible side effects include nausea, dizziness, sleepiness, changes in perception, and increased blood pressure or heart rate. More serious problems can occur, including excessive sedation or breathing difficulties. Repeated exposure may carry liver or bladder risks, and ketamine has misuse potential.

Screening, supervised administration, and follow-up help manage these risks but do not eliminate them. Your clinician will explain which concerns are most relevant to you.

Will insurance cover treatment?

Coverage varies, and out-of-pocket payment may be required. Before scheduling infusions, ask about the consultation fee, treatment costs, insurance verification, and anticipated follow-up.

You don’t have to make this decision alone.

If your current treatment plan isn’t providing enough relief, a consultation can help you understand what options remain.

Bring your questions, your treatment history, and your goals. APG’s pain management team can help you decide whether ketamine infusion therapy—or another approach—is an appropriate next step.

Request a consultation with APG Pain Management.

Requesting a consultation does not commit you to treatment.

If you are experiencing a mental-health crisis, call or text 988. For immediate danger or a medical emergency, call 911.

Sources & Further Reading

• American Society of Regional Anesthesia and Pain Medicine, American Academy of Pain Medicine, and American Society of Anesthesiologists. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain. Regional Anesthesia and Pain Medicine, 2018. Guidance on patient selection, potential benefits, treatment protocols, monitoring, and safety. Read the guidelines

• ASRA Pain Medicine. Ketamine for Chronic Pain: Who, When, and How? September 11, 2026. An overview of appropriate candidates, treatment goals, expected responses, and considerations for repeat treatment. Read the article

• National Institute of Mental Health. Cracking the Ketamine Code. October 27, 2023. Background on ketamine research for treatment-resistant depression and the development of esketamine. Read the article

• National Institute of Mental Health. Side Effects Mild, Brief with Single Antidepressant Dose of Intravenous Ketamine. November 18, 2019. Findings from NIH studies examining short-term side effects after a single low-dose infusion. These findings do not establish the safety of repeated infusions or long-term treatment. Read the research summary

These resources provide general educational information. They do not replace an individualized medical evaluation or establish that ketamine is appropriate for every patient.