Ketamine and Spravato at MyNeuPath Long Beach
A clinically supervised, mechanism-different option for treatment-resistant depression.
Ketamine therapy works through the brain's glutamate system — a different mechanism than traditional antidepressants. For carefully selected patients with treatment-resistant depression, PTSD, or severe symptoms after multiple prior medication trials, it can open a different pathway. At MyNeuPath in Long Beach, ketamine treatment is delivered in a monitored clinical setting with thorough safety screening, careful integration with therapy, and honest framing about what each form of ketamine therapy is and is not.
Two different pathways
Generic ketamine
Used off-label for treatment-resistant depression, PTSD, and certain other conditions in clinically supervised settings. Delivered most commonly intramuscular, intravenous, or in some clinical settings as a sublingual or nasal preparation. Dosing is individualized.
Insurance coverage for off-label ketamine is variable; many plans do not cover it. We verify benefits and explain expected cost before scheduling.
Spravato (esketamine)
An FDA-approved nasal-spray medication for treatment-resistant depression. Delivered in a certified treatment center under a mandatory REMS monitoring program: patients self-administer the nasal spray under direct clinical supervision, then remain for a monitored observation period after each dose.
Spravato is covered by most major insurance plans when medical-necessity criteria are met. We verify benefits and document the prior antidepressant trials needed to support a prior authorization.
How ketamine works (differently from traditional antidepressants)
Most antidepressants work by adjusting levels of monoamine neurotransmitters — serotonin, norepinephrine, dopamine — through gradual changes that often take weeks to register clinically. Ketamine acts primarily through the brain's glutamate system, which is involved in synaptic plasticity and the brain's ability to form and reshape connections. Patients who respond to ketamine often notice symptom changes much faster than they would with a typical antidepressant trial — sometimes within hours or days rather than weeks.
The faster onset is not a guarantee, and ketamine is not a cure. For many patients who benefit, the most durable gains come when ketamine sessions are paired with ongoing therapy or other treatment so that the window of greater neural flexibility translates into lasting therapeutic work.
Who ketamine therapy is for
Ketamine or Spravato may be considered for adults with:
- Treatment-resistant major depression — most often defined as inadequate response to at least two prior antidepressant trials at adequate dose and duration.
- Severe depression with significant functional impairment where a faster-acting option may be clinically appropriate.
- PTSD in selected patients, in coordination with trauma-focused therapy. This is an off-label use.
Safety screening is essential
Ketamine is not appropriate for everyone. Before any treatment, we screen for:
- Cardiovascular history — uncontrolled hypertension, recent cardiac events, or arrhythmias may rule out ketamine entirely.
- Psychiatric history that could be worsened by dissociative effects (e.g., active psychotic symptoms).
- Substance-use history — particularly any history of ketamine misuse.
- Pregnancy, certain medication interactions, and other medical contraindications.
If safety screening rules out ketamine, we discuss alternatives — TMS, PrTMS, EMDR, medication-management changes, or therapy.
What a treatment session looks like
- Pre-session check. Vitals, current symptoms, and any medication or food intake since the last session.
- Administration. Depending on the form, this is either an intramuscular or intravenous administration of ketamine, or a self-administered Spravato nasal-spray dose, all under direct clinical supervision.
- Monitored recovery. Patients remain in the clinic for a monitored observation period — typically two hours for Spravato per the REMS protocol, comparable observation for generic ketamine. Vitals are tracked throughout.
- Discharge with a driver. Patients cannot drive themselves home after a session. We help coordinate transport logistics if rides or rideshares are part of the plan.
- Integration. Many patients benefit from a therapy session in the days following each treatment to consolidate the work and translate symptom relief into durable change.
[CONFIRM: which ketamine pathways MyNeuPath specifically delivers — generic ketamine route (IV / IM / intranasal), Spravato yes/no, dosing protocol, and whether the clinic offers ketamine-assisted therapy with paired sessions.]
What the evidence says
Spravato (esketamine) is FDA-approved for treatment-resistant depression based on a series of randomized controlled trials. The approval includes the REMS monitoring requirement specifically because of the dissociative and sedation effects that occur during the dosing window.
Generic ketamine for depression has a substantial published evidence base — primarily randomized controlled trials and open-label studies — supporting rapid antidepressant effects in treatment-resistant samples. The evidence is strong enough that off-label use is widely considered clinically reasonable in appropriate patients, but it is not FDA-approved for this indication, and we say so clearly.
Every clinical claim on this page is anchored either in the FDA's Spravato approval record or in published peer-reviewed primary literature for ketamine. We do not cite manufacturer marketing aggregates or wellness-industry framing. Ask your clinician for the specific citations underlying a recommendation.