This guide to intramuscular ketamine explains how IM ketamine works, its benefits, and how it compares to other administration methods. Intramuscular (IM) ketamine is an effective treatment option for depression, PTSD, and anxiety. At McLean NTC, we provide personalized care to help you find the relief you need.
What is IM Ketamine?
Intramuscular (IM) ketamine involves injecting ketamine directly into a muscle, typically in the shoulder or thigh, for rapid absorption into the bloodstream. IM ketamine is commonly used in medical settings as an anesthetic for procedures like pain relief in emergency departments, and has more recently been explored as a treatment for psychiatric disorders, particularly depression.
While most research on ketamine for mental health has focused on intranasal and intravenous (IV) administration, studies have shown that IM ketamine can effectively alleviate psychiatric symptoms with rapid-acting and sustained results.
At McLean NTC, we’re a trusted provider of both IM and intranasal esketamine (Spravato). Patients can choose the treatment approach that best suits them, according to their individual needs.
How Does IM Ketamine Work
Ketamine’s therapeutic effects are often explained by its interaction with NMDA receptors (NMDARs), proteins essential for learning and memory. By blocking these receptors, ketamine triggers a range of neurological changes that can help relieve psychiatric symptoms.
Ketamine boosts signaling in the prefrontal cortex (PFC), the brain area that regulates mood and cognition. It increases synaptogenesis—the creation of new connections between nerve cells—helping to repair damaged pathways often seen in mood disorders.
Ketamine also enhances functional connectivity, which can help different brain regions communicate more effectively. This may help break patterns of negative thinking that are common in conditions like depression.
Conditions Treated by IM Ketamine
IM ketamine treatment can relieve symptoms in multiple psychiatric diagnoses. IM ketamine treatment improved symptom scores in people with depression, anxiety, and post-traumatic stress disorder (PTSD) in one analysis of real-world patient data. Case reports have also demonstrated IM treatment could be useful in bipolar depression, particularly in helping reduce symptoms of depression and suicidality.
IM ketamine may be especially useful for those with treatment-resistant depression (TRD), with many studies showing it can provide relief when other treatments have failed to do so. At McLean NTC, we specialize in evidence-based treatments for TRD, providing ketamine and TMS as promising alternative treatments for people battling with hard-to-treat depression.
In a series of case reports, IM ketamine treatment significantly reduced depression symptoms in people with co-morbid TRD and eating disorders. The patients also showed mild improvement in eating disorder symptoms at the study end.
What to Expect with IM Ketamine Treatment at McLean NTC
Before starting IM ketamine treatment, you’ll have a pre-screening call with a team member to discuss eligibility. If eligible, we’ll schedule an evaluation with Dr. Haq, who will go over treatment details, answer questions, and review your symptom history to complete your assessment.
During the treatment session, ketamine is injected directly into a large muscle, usually in the thigh or shoulder. After the injection, the effects start within a few minutes and can last for about 30-60 minutes, with some lingering effects for a few hours. During this time, you may experience mild dissociation characterized by feeling separate from your body and sense of reality. A provider will monitor you during this time to ensure your comfort and safety.
At each IM Ketamine appointment, you will be required to stay for at least one hour of post-administration monitoring. After this time, our staff will assess whether the effects of the treatment have subsided enough for you to leave safely. If you have a designated driver and are deemed ready to depart, you may then exit the clinic under their care. Our staff will provide you with advice about the best aftercare.
To ensure the best chances for clinical improvement, IM Ketamine treatments start with two treatments per week for the first four weeks, then one treatment per week for the following two weeks, then one treatment every other week or as needed and discussed with Dr. Haq.
Risks and Side Effects
Common Side Effects of intramuscular ketamine can include:
- Sedation
- Dizziness
- Dissociation
- Confusion
- Nausea and vomiting
- Temporary increase in heart rate and blood pressure
Studies show these side effects tend to be tolerable, mostly wearing off after the drug effects have worn off. However, there remains limited data about the long-term risks of IM ketamine. As such, those undergoing IM treatment at McLean VA will be closely monitored throughout the course of their treatment, and regular follow-up sessions will be held to check patient safety.
Comparing IM Ketamine to Other Treatments
When considering ketamine therapy for mental health treatment, it can be challenging to know which approach is best. Each method offers unique benefits and limitations and is best suited for different therapeutic approaches. For instance, ketamine in oral tablets is best for people using ketamine in at-home settings. In contrast, IM and IV setups and intranasal ketamine in the form of Spravato are conducted in controlled clinical settings under the supervision of medical professionals.
| Treatment type | Intramuscular (IM) | Intravenous (IV) | Spravato |
| Efficacy | Shown to be as effective as IV ketamine | Ketamine is well-absorbed into the bloodstream; rapid onset; well-studied for multiple psychiatric diagnoses | Similar effectiveness in treating depression to IV in studies but may take longer to see results |
| Cost | Cheaper than IV | Generally high (up to $800 per treatment) | Accepted by most insurances if treatment history meets criteria, but more expensive if entirely out-of-pocket |
| Risks | Similar safety profile to IV but less risk of vein-related complications | Requires close monitoring; small risk of complications such as vein irritation, phlebitis, or thrombosis | Moderate side effects; patients may experience nasal discomfort |
| Patient needs | Suitable for patients needing a single-session or rapid relief without the need for IV. | Requires IV setup, monitored setting; ideal for those needing rapid and strong effect | Spravato is specifically approved for those with TRD and major depressive disorder (MDD) with suicidal ideation; good option for those uncomfortable with injections |
Why Choose IM Ketamine in McLean VA?
If you’re struggling with TRD, IM ketamine could be an effective option for rapid relief without higher costs or added complications associated with IV ketamine. Our expert team provides personalized care and compassionate support as we guide you toward a successful recovery from depression.
If you want to learn more, contact our office to speak with one of our members or book a consultation through the McLean NTC website.
FAQs
Q: Why might someone choose IM ketamine over other forms like intranasal or oral ketamine?
IM ketamine can offer faster relief than oral forms, as it bypasses the digestive system and enters the bloodstream directly. While intranasal options are also effective, IM ketamine is sometimes preferred for its quick onset and ability to deliver precise doses. For patients seeking a middle ground between IV and intranasal ketamine, IM offers a balance of ease of administration with rapid therapeutic effects.
Q: How long do the benefits of IM ketamine last after a treatment session?
A: The duration of IM ketamine’s effects can vary widely, depending on the individual’s condition and response to treatment. Many patients report relief lasting from several days to weeks after each session. Over a course of treatments, some people experience cumulative benefits that lead to longer-lasting symptom improvement. At McLean NTC, we can help develop a maintenance plan tailored to your specific needs and response.
Q: Are there any preparations needed before an IM ketamine treatment?
A: It’s often recommended to avoid certain foods or substances for a few hours before the session. Additionally, you’ll need to have transportation home arranged since it is illegal to drive back while the drug effects may still be lingering. You’ll also need to allow time to rest after the session.
Sources
- https://pubmed.ncbi.nlm.nih.gov/29532791/
- https://journals.sagepub.com/doi/full/10.1177/20451253231171512
- https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-04268-5