Maintenance Dosing: Sustaining Response After Induction
Most responders need some form of continued treatment to sustain benefit. There is no consensus on the best schedule — only competing models with different trade-offs.
This page has been written and edited by the publisher. It has not been reviewed by a licensed clinician.
Three common maintenance models
1. Fixed-interval boosters
A single session every 2-6 weeks on a calendar schedule. Predictable and easy to plan around. Risk: receiving treatment you may not need.
2. Tapering schedule
Progressively widening the interval (weekly → biweekly → monthly → quarterly) until symptoms guide stopping. The default for many depression patients.
3. Symptom-triggered (PRN)
No scheduled sessions. Patients return for a booster when symptoms recur to a defined threshold. Requires honest self-monitoring and a responsive clinic.
What the evidence supports
- Maintenance reduces relapse rates vs. discontinuation alone in TRD (Wilkinson 2018).
- No randomized trials definitively favor one schedule over others.
- Long-term safety data beyond 1-2 years remains limited.
Questions to ask your provider
- What signals will tell us it's time to space out or stop?
- How will we monitor for tolerance or escalation?
- What's the off-ramp plan from day one?
Publisher and editor of Ketalux, based in Chicago, Illinois. Ira is a ketamine therapy patient, not a clinician. This is editorial review, not medical review: Ira is not a licensed clinician and does not provide diagnosis or medical care. Ketalux does not accept compensation from providers in exchange for favorable editorial coverage, evidence ratings, recommendations, patient referrals, or organic provider ranking. Read the full publisher disclosure →
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.