How Many Ketamine Therapy Sessions Will You Need?
The answer depends on which form of ketamine therapy you’re receiving, how your symptoms respond, and how long your remission lasts. But generally speaking, you’ll need a lot more treatment sessions with the esketamine nasal spray Spravato than you will with IV ketamine therapy.
Here’s a quick look at the numbers, but be sure to read the details below—there’s important nuance and context behind how these figures were determined.
These numbers were gathered from clinical guidelines, research studies, and prescribing information from authoritative sources such as the American Psychiatric Association (APA), the American Society of Ketamine Physicians (ASKP), and the FDA’s official prescribing information for Spravato.
IV ketamine treatment protocols vary across clinics since it is used off-label for depression, but best-practice guidelines typically recommend an induction phase of 4–6 infusions over 2–3 weeks, followed by a maintenance phase with less frequent boosters. The numbers used in this table reflect commonly accepted clinical practices as outlined by ASKP, VA clinical protocols, and research reviews on IV ketamine for treatment-resistant depression.
In contrast, Spravato is FDA-approved, and its administration schedule is mandated by the FDA-approved label, which requires twice-weekly dosing for the first month, then weekly or biweekly maintenance thereafter. While individual clinics may adjust treatment frequency based on patient response, the numbers presented represent widely recognized, evidence-based protocols. The median total sessions were calculated by averaging the minimum and maximum treatment frequencies observed across these sources.
IMPORTANT: Session Counts Vary by Patient
The number of sessions in my table above are not absolutes—ketamine therapy is highly personalized, and no two patients follow the exact same schedule. Some people may find lasting relief sooner than expected, while others may require more sessions to maintain progress.
For instance, while the average for Spravato is 24 sessions, that doesn’t mean everyone will need exactly 24. Some may achieve remission after 12 sessions and stop, while others might continue with 30 or more. The right number of treatments depends on individual response, medical guidance, ongoing evaluation, and what you need to prevent relapse.
What Those 10 Extra Spravato Sessions Mean For You
Choosing Spravato over IV ketamine means committing to about 10 more treatment sessions over six months—a 54% to 75% increase. That’s not just a number. It’s time, cost, logistics, and lifestyle adjustments that could shape your entire treatment experience.
That’s 10 extra trips to the ketamine clinic. More days rearranging your schedule. More time off work—because Spravato requires a two-hour monitoring period after every dose (Spravato sessions are about 35 minutes longer than IV ketamine infusion therapy). And then there’s cost. Each session means another copay, another bill, another financial hit. Spravato is wildly expensive. Even with insurance, your out-of-pocket costs will be more than self-paying 100% of IV ketamine. (although your costs could go down to almost nothing if you qualify for the manufacturer’s subsidy).
Logistics matter too. If you rely on a ride after treatment, that’s 10 more favors from friends or extra rideshare expenses.
The takeaway? There’s a lot of weight to these numbers, and what they mean for you depends on your unique situation. If you qualify for insurance subsidies, Spravato could be far more affordable than IV ketamine. But if time, scheduling, and travel are major concerns, IV ketamine’s less frequent treatments might make it the better fit (if you can afford it).
I did 30 Spravato Sessions
I reached full remission after session #11—about six weeks. So why didn’t I stop then? Dr. Giles, the clinic’s psychiatrist, put it plainly: “Now that you’re in remission, your job is to stay in it.”
Besides, there was NO WAY I was going to walk away before finishing the protocol. What if the remission was just a trick of the light? A temporary reprieve before the darkness crept back in? Depression has a way of doing that—just when you think it’s gone, it finds a way to return. I couldn’t risk that. It felt like stopping antibiotics too soon—sure, I felt better, but would I keep feeling better if I stopped the full course? Wouldn’t the infection come back?
But why 30 sessions? The truth is, I didn’t need them after session #20. I kept going because I could. Insurance and the manufacturer’s subsidy brought the cost down to about $10 a session—why not take advantage?
But even as I type this I’m not entirely sure that’s the reason. Every session is a logistical headache—coordinating rides, feeling guilty for asking friends and family, spending money I didn’t have on ride shares. And after a session, forget working—my day was shot. So, if this was just about getting my money’s worth, why did I keep putting myself through all that? The answer probably lies somewhere in between not needing it and the fear of relapse.