The quality gap between ketamine clinics is enormous and the industry is lightly standardized. Ten questions that separate well-run programs from storefronts.
Ketamine treatment has no standard protocol and no accreditation body. That means the difference between an excellent clinic and a careless one is invisible from the website — and often only surfaces in the questions you ask. Here are ten, and what good answers sound like.
1. Who is in the room during my dose?
A physician, psychiatrist, CRNA, or registered nurse with monitoring duties — not a technician. Every ketamine dose carries labeled risks of sedation, dissociation, and blood-pressure changes 1; supervision is the safety floor.
2. What does your screening process exclude?
A good clinic screens for uncontrolled hypertension, psychosis history, active substance misuse, pregnancy, and relevant cardiac conditions — and will tell you "no" if you fail. A clinic that books you without screening is telling you how it handles risk in general.
3. What exactly is the protocol?
Number of infusions, session length, spacing, dose range, and what happens after the initial course. Vague answers here ("we tailor everything") without any structure usually mean no structure.
4. Is esketamine an option, and is the setting REMS-certified?
If your diagnosis matches an approved use — treatment-resistant depression, or MDD with acute suicidal ideation or behavior — SPRAVATO® may be covered by insurance 1, which changes the economics entirely (see our insurance guide). It requires a REMS-certified setting with two hours of post-dose monitoring.
5. What is the total cost, including the course I'm not thinking about yet?
Get the initial course price and the maintenance price in writing. Our cost guide lists the ranges and the hidden line items (screening fees, monitoring, bundled therapy).
6. What do you do when a session goes badly?
Every experienced program has a story: a patient who became distressed, hypertensive, or nauseated. Ask what their protocol is. Hesitation here is disqualifying.
7. How do you decide whether treatment is working?
Legitimate programs measure depression scores (PHQ-9 or similar) before and during treatment and will stop a course that isn't working rather than upsell maintenance.
8. Do you offer esketamine, IV, IM, and oral — or only one?
Clinics that offer only one route have an incentive to recommend it for everyone. Our ketamine vs. esketamine comparison and complete 2026 guide explain when each route fits.
9. Can I talk to the prescriber before booking?
A screening call with the actual clinician — not a salesperson — is standard at well-run clinics.
10. What do you tell patients the evidence does not support?
This is the honesty test. A trustworthy clinic will tell you IV ketamine's psychiatric use is off-label, that evidence for anxiety, PTSD, OCD, and pain varies (see our condition guides), and that no one can promise an outcome. Clinics that promise results are the clearest red flag on this list.
How our directory helps
Every listing in our provider directory shows location, contact details, insurance acceptance, and treatment details so you can pre-screen before making the first call — and our first-infusion walk-through tells you what a well-run session should look and feel like from the inside.
Sources
- FDA Prescribing Information for SPRAVATO® (esketamine), revised January 2025: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/211243s016lbl.pdf. Screening and protocol patterns are editorial interpretation based on publicly reported clinical practice, not a standard or endorsement.
More reporting on patient experience.
This report is educational and is not medical advice. Coverage, availability and eligibility can change; verify details with the named source or your care team.