The Induction Series: 6 Infusions in 2-3 Weeks
Most ketamine programs begin with a tightly spaced series of sessions designed to establish response before tapering to maintenance.
The classic IV induction
- Dose: 0.5 mg/kg over 40 minutes, IV.
- Frequency: 2-3x per week.
- Total: Six infusions over ~2-3 weeks.
- Decision point: Reassess at session 4-6. If no response, most clinicians stop or pivot.
How modalities differ
- IM ketamine: Usually 6-8 sessions on a similar 2-3x weekly cadence; dosing 0.5-1.0 mg/kg.
- Spravato (esketamine): FDA induction is 8 sessions over 4 weeks (twice weekly).
- Sublingual/oral: Often longer induction windows (8-12 sessions, weekly to biweekly) due to lower bioavailability and gentler profile.
- KAP infusion: Lower-frequency model (e.g., 3-6 sessions over 6-12 weeks) interleaved with therapy.
What outcomes typically look like
In trials of TRD, ~50-70% of patients show clinically meaningful response by the end of induction, with ~30% reaching remission. Non-response by session 4-6 is the strongest predictor of non-response overall — continuing further rarely converts non-responders.
After induction
Responders move to maintenance. The shape of maintenance — fixed boosters, taper to none, or symptom-triggered — depends heavily on which condition was treated and how you responded.
Educational use only. The content on this page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Ketamine and related therapies carry risks and are appropriate only under qualified medical supervision. Always consult a licensed healthcare professional about your individual situation. Information may change as research evolves.