About Ketamine

Is my ketamine medication FDA-approved?

Ketamine has been FDA-approved since 1970 and has a well-established safety record in medicine. Your medication is prescribed by a licensed provider under that approval. The specific compounded formulation you receive is custom made for you by a licensed compounding pharmacy to meet your individual clinical needs. Compounded medications are not FDA-approved finished products, but are legally prepared and dispensed under federal and state pharmacy law. Our pharmacy is accredited by the Pharmacy Compounding Accreditation Board (PCAB) which is the highest standard of quality and safety in compounding. If you have questions about your medication or how it is prepared, your care team is happy to help.

What are the side effects of ketamine?

Most side effects are mild, temporary, and resolve shortly after your dose. Commonly reported effects include nausea, dizziness, drowsiness, dissociation, and temporary changes in blood pressure or cognition. A light snack before dosing can help with nausea. At the low doses used in our program, dissociation is typically mild if it occurs — mention it to your prescriber. Every person responds differently. If something feels concerning after dosing, reach out to your care team. Side effects from compounded medications can be reported to the FDA at fda.gov/medwatch/report.htm. In a medical emergency, call 911.

Can I become addicted to ketamine?

Ketamine is a controlled substance, meaning it is regulated by the government due to its potential for misuse. Controlled substances are rated on a schedule from I (high abuse potential, no accepted medical use) to V (lowest abuse potential). Ketamine is Schedule III — it has recognized medical use and a lower potential for dependence than Schedule I or II drugs, but it is not without risk. In supervised therapeutic settings, addiction risk is considered low. Your dose is carefully prescribed and monitored, and your pharmacy does not dispense early refills. If you feel you need more, contact your care team rather than adjusting on your own. If you have a personal or family history of substance use, let your provider know before starting treatment.

What if I am currently taking Spravato (esketamine)?

Spravato (esketamine) and compounded ketamine (esketamine/arketamine) share the same active compound and cannot be taken concurrently. Taking ketamine from more than one source at a time carries real safety risks, and our first commitment is always to your wellbeing. As part of our care process, our clinical team reviews the Prescription Drug Monitoring Program (PDMP) which is a state-run database that tracks controlled substance prescriptions. We do this not to police your history, but to make sure we have a complete picture of your health so we can support you safely and thoughtfully. If we find that you are currently receiving esketamine or ketamine through another provider, we won't be able to move forward with our program at that time. If you're hoping to transition away from Spravato, that's a conversation worth having with your provider and we're happy to help you think through the next steps. Please share any current or recent ketamine use during intake so your care team can support you in navigating this with care.

Before Your Dose (Preparation and Safety)

Can I drink alcohol while on ketamine treatment?

Do not drink alcohol around the time of your dose. Alcohol and ketamine both affect the central nervous system, and combining them can increase sedation and compromise your safety. Beyond the immediate interaction, alcohol can also work against your treatment. Ketamine supports your brain in forming new connections, and alcohol can blunt that process. If you drink regularly or have questions about how alcohol might affect your treatment, talk to your provider. They can give you guidance specific to your situation.

When can I drive after taking my ketamine dose?

Do not drive or operate heavy machinery after taking your dose until you are fully alert and clear-headed. This is especially important early in treatment, before you know how your body responds to ketamine. Talk to your provider about timing around driving based on your dose and individual response.

Can I take an additional dose outside of my prescribed schedule?

No. Do not take extra doses outside of your prescribed treatment plan, even if you are having a difficult day. Your dosing schedule has been designed by your provider based on your individual needs. If you are struggling, contact your care team. They can discuss whether an adjustment to your treatment plan is appropriate.

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is close to the time of your next scheduled dose. In that case, skip the missed dose and resume your regular schedule. Do not take two doses to make up for a missed one. If you are unsure what to do, contact your care team.

During and After Your Dose

What should I do if I feel dizzy?

Dizziness is a common side effect of ketamine and is usually temporary. If you feel dizzy during or after your dose, sit or lie down in a safe, comfortable position and allow it to pass — this typically resolves on its own within a short period of time. Do not stand up quickly, drive, or operate machinery until you feel fully alert and steady. If dizziness is severe, persistent, or accompanied by chest pain, difficulty breathing, or loss of consciousness, call 911.

What should I do in an emergency?

Call 911 immediately. If you have taken ketamine, inform emergency responders and provide your dose if known. If you are experiencing a mental health crisis, call or text 988 (Suicide and Crisis Lifeline), available 24/7. You can also reach the Fireside Project at 62-FIRESIDE (623-473-7433), a free peer support line available during and after difficult experiences. For non-emergency clinical concerns, contact your care team. Please note that Leven Health is a telehealth service and is not available 24/7.

What should I do if I have a question about my symptoms?

Contact your care team. Do not adjust your dose or stop taking your medication without speaking with your provider first. If you are experiencing a medical emergency, call 911.

How long until I notice results?

Ketamine works differently than traditional antidepressants, which can take 6–8 weeks before you notice any change. Many people report noticing a difference sooner, though individual responses vary. Because your medication is compounded, your clinician can tailor your dose specifically to your needs — adjusting over time based on how you respond. This flexibility is one of the key advantages of a compounded ketamine treatment program. Results will depend on your individual response and treatment plan. Discuss what to expect with your provider so they can help set realistic expectations and adjust your treatment as needed.

Is ketamine treatment a long-term commitment?

Not necessarily — and our goal is to get you to a place where you may not need medication at all. Our goal is not to keep you on medication indefinitely. Many patients experience durable improvements that allow them to taper off over time. Your treatment length will depend on how you respond. Some people complete a shorter course, others benefit from continued support longer term, and for some, ongoing treatment is the right choice. We also encourage you to build in non-pharmacological support alongside your treatment with therapy, exercise, sleep, mindfulness, and social connection. These can strengthen and extend the benefits of your ketamine treatment and support lasting recovery on your own terms. Your provider will work with you every step of the way to evaluate your progress and find the right path forward for you.

What can I do to support my treatment beyond medication?

Ketamine works best as part of a broader commitment to your wellbeing. There are a number of things you can do alongside your treatment to strengthen and extend your results:

• Therapy. Working with a therapist, particularly one familiar with ketamine-assisted treatment, can help you process and integrate your experiences and build lasting change. Some patients find it beneficial to take a dose prior to a therapy visit — discuss this with your provider and therapist to see if it is right for you.

• Exercise. Regular physical activity has well-established benefits for mood, anxiety, and overall mental health.

• Sleep. Prioritizing consistent, quality sleep supports your brain's ability to form the new connections that ketamine helps create.

• Mindfulness. Practices like meditation and breathing exercises can reduce stress and help you stay present.

• Nutrition and routine. Regular meals, a stable daily schedule, and reducing alcohol can reinforce the progress you make in treatment.

• Social connection. Meaningful relationships and reducing isolation are among the most protective factors for mental health.

These are not just add-ons — they can meaningfully extend the durability of your results and, over time, reduce your reliance on medication. Talk to your provider about which approaches make the most sense for you.

What should I do if my medication was left outside during delivery?

Ketamine troches can melt if exposed to heat. If your medication was left outside, bring it inside immediately and store it in a cool, dry place away from heat, moisture, and direct sunlight. If your medication shows any signs of melting, softening, or deformation, do not use it. Contact your care team or pharmacy for guidance on whether a replacement is needed.

What should I do if my medication was stolen?

File a police report immediately and contact your care team. As a controlled substance, a police report is required before a replacement can be considered. Your care team will review your case and work with you on next steps.

Will my ketamine treatment show up on a drug test?

Most likely not. Standard workplace drug tests including 5-panel, 10-panel, 12-panel, and DOT-mandated tests do not automatically screen for ketamine. Detection only occurs if an employer or organization specifically orders an expanded toxicology panel that includes ketamine. It is important to know that ketamine is a legal medication. Ketamine is a legal, Schedule III controlled substance that has been used in medicine since 1970. When prescribed by your provider and taken as directed, you are consuming it legally and under clinical supervision. If you are subject to specialized testing such as probation, legal monitoring, military service, professional athletics, or certain safety-sensitive employment, ketamine may be detectable. If you are prescribed ketamine therapeutically, inform your testing facility beforehand with documentation from your provider. If you have concerns about drug testing in your specific situation, contact your care team. They can provide documentation of your prescription if needed.

Who has access to my medical information?

Your medical information is private and protected under HIPAA. It is only shared as needed to provide your care such as with your pharmacy or collaborating providers. It is not sold or shared for any other purpose without your consent, except as required by law. As with all controlled substances, your prescription will be reported to your state's Prescription Drug Monitoring Program (PDMP) — a confidential database used by licensed prescribers and pharmacists to promote safe prescribing. This is a standard regulatory requirement and is not unique to ketamine. If you have questions about your privacy rights or how your information is handled, contact us at [email/phone].

Is ketamine safe for long-term use?

Yes. When prescribed and monitored by a licensed medical provider, ketamine has been used safely over extended periods. Like any medication, long-term use requires ongoing clinical oversight to ensure it continues to be the right fit for you. Your care team will check in with you regularly to monitor your overall health and response to treatment. If you notice any new or changing symptoms, let your care team know promptly rather than waiting for your next scheduled visit. Regular check-ins with your provider are an important part of safe, long-term treatment.

What should I do if I have a question about billing, shipping, or my account?

Contact our support team at care@fractus.health. We're here to help.

Who is ketamine treatment appropriate for?

Ketamine treatment may be appropriate for adults experiencing conditions such as depression, treatment-resistant depression, anxiety, PTSD, OCD, or related mood disorders who have not found adequate relief through other treatments. Eligibility is determined on an individual basis through a thorough clinical intake process. Some conditions make ketamine treatment unsuitable. You will not be eligible for our program if you have a current diagnosis of schizophrenia or schizoaffective disorder, active psychosis, active mania, active suicidal ideation with a plan or intent, a history of ketamine misuse or use disorder, or if you are currently pregnant or breastfeeding. These are not exhaustive examples, and your care team will review your full history during intake. Other conditions may require additional evaluation before proceeding. Your provider will discuss these with you as part of the intake process. Because eligibility is highly individual, the best way to find out if this program is right for you is to complete our intake. Your care team will review your history and work with you to determine whether ketamine treatment is appropriate for your situation.

What happens if I take too much?

Do not take more than your prescribed dose. If you have taken more ketamine than prescribed, do not drive or operate machinery. Stay in a safe, comfortable position and have someone with you if possible. Symptoms of too much ketamine can include extreme dizziness, confusion, severe dissociation, difficulty breathing, or loss of consciousness. If you experience any of these, call 911 immediately and inform responders of what you have taken and how much. If you are unsure whether you have taken too much, contact your care team or call Poison Control at 1-800-222-1222.

Can I take ketamine if I am pregnant or breastfeeding?

No. Ketamine is not appropriate for use during pregnancy or while breastfeeding. If you become pregnant during treatment, stop taking your medication and contact your provider immediately. If you are of childbearing age, your provider will discuss contraception as part of your care plan. Please be open with your care team about any changes in your reproductive health so they can support you safely.

How does ketamine work?

Ketamine works differently than most traditional antidepressants. Traditional antidepressants work gradually over weeks by adjusting neurotransmitter levels. Ketamine works through a different mechanism, acting on NMDA receptors in the brain to block excess glutamate activity. Glutamate is the brain's primary excitatory neurotransmitter, and in depression and related conditions, its signaling can become dysregulated. By modulating this system, ketamine rapidly promotes the growth of new neural connections. Many people notice a difference within days rather than weeks. The program uses very low doses, sometimes called sub-dissociative or psycholytic doses. This is different from what most people associate with ketamine. The goal is not to produce a dissociative or hallucinogenic experience. At these doses, the aim is gentle mood support and neural restoration, not an altered state. Ketamine also clears your system relatively quickly. Unlike some medications that stay in your body for weeks, ketamine has a short half-life, meaning it does not accumulate significantly between doses. This makes it easier to adjust and personalize your treatment as you go.

What if it stops working?

It is not uncommon for the effects of any treatment to shift over time. If you feel your medication is becoming less effective, contact your care team. Do not adjust your dose on your own. Your provider may adjust your dose, change your dosing schedule, or recommend a planned break to allow your system to reset. Treatment response is monitored regularly and your plan will be updated based on how you are doing.