Most patients who begin ketamine therapy have spent months or years trying treatments that did not provide adequate relief — which means arriving at our clinic often comes with a complicated mix of cautious hope and well-earned skepticism. At Minnesota Ketamine & Wellness Institute, we want that first month to feel as clear and supported as possible, so we are laying out exactly what the treatment arc looks like, week by week. Understanding the structure of the process helps patients engage with it more fully, and that engagement matters for results.
How the First Month Is Structured
The standard protocol at our clinic is six infusions administered over two to three weeks, followed by an evaluation period and, for most patients, the beginning of a maintenance plan. That structure is grounded in research showing that both single and repeated ketamine infusions can treat depression and related conditions, with repeated sessions producing cumulative antidepressant benefits and extending remission periods (American Journal of Psychiatry). The first month, then, covers the full initial series plus the early phase of understanding how your system has responded.
Before the first infusion begins, you will complete an intake assessment. Your provider will review your full health and medication history, walk through how ketamine works, explain what to expect during the infusion experience, and answer your questions. Plan for approximately one and a half to two hours for that first appointment. Each subsequent infusion appointment runs approximately one hour, including the 40 minutes of active infusion time and a 30-minute recovery period before discharge.
Week One: The Intake and First Two Infusions
The first week typically includes your intake assessment and your first one or two infusions depending on how your schedule is arranged. The intake is not a formality — it is a genuine clinical evaluation that shapes your treatment plan. Your provider will review any medications you are currently taking, since certain substances affect ketamine’s efficacy. Daily benzodiazepines such as Klonopin, Xanax, and Ativan can interfere with how well ketamine works, as can Lamictal at doses above 100mg per day. Those factors are assessed before your first infusion, not discovered afterward.
Your first infusion is the one most patients approach with the most apprehension, which is understandable. The sensory experience — a floating sensation, mild dissociation, light and sound sensitivity — is unfamiliar, and unfamiliar things can feel unsettling even when they are proceeding exactly as expected. What most patients find is that knowing what is coming makes the experience significantly more manageable. Our clinical team monitors vital signs throughout every session and is present to check in on your comfort level. The first session is often the most tentative; by the second, most patients have a better sense of how to settle into the experience.
Week Two: Infusions Three and Four — When the Cumulative Effect Builds
The second week is where many patients begin to notice something shifting. Research confirms that repeated ketamine infusion sessions produce cumulative antidepressant benefits — the effect builds with each session in a way that a single infusion cannot replicate on its own (National Institutes of Health). This is not linear or predictable for every patient, and results vary by individual, but week two is often when the question changes from “is this doing anything?” to “something feels different.”
That shift, when it happens, is rooted in what ketamine does at the neurological level. Ketamine promotes neuroplasticity — the brain’s ability to form and reorganize neural connections — which may explain why repeated sessions deepen and extend the therapeutic effect (National Institutes of Health). Think of it as the difference between opening a door once and widening the doorframe. Each infusion contributes to a structural change, not just a temporary chemical one.
This is also the week where the value of integration therapy becomes clearest for patients who have chosen to combine infusion treatment with psychotherapy. Our clinic offers preparation and integration psychotherapy sessions with our licensed therapists, scheduled separately from infusions and typically available on Tuesdays and Thursdays following infusion appointments. If you are pursuing KAP — ketamine-assisted psychotherapy — these sessions give you a structured opportunity to process what arises during the infusion experience and carry it forward into daily life.
Week Three: Infusions Five and Six — Completing the Initial Series
The third week brings the fifth and sixth infusions, completing the initial series. For most patients, this is also the week that produces the clearest picture of how they are responding. Some patients experience significant symptom reduction by this point; others respond more gradually. There is no single correct trajectory, and our team evaluates response on an individual basis rather than against a fixed benchmark.
The sixth infusion is not an ending — it is a transition point. After the initial series, the conversation shifts to what ongoing care looks like. Maintenance infusions are typically recommended and are usually administered once every two to eight weeks depending on individual response. The research base supports maintenance infusions as a meaningful strategy for extending the remission periods that the initial series establishes (American Journal of Psychiatry). Maintenance infusions at our clinic are priced at $400 per session, compared to $500 per session for the initial series.
Week Four: Evaluation and the Transition to Maintenance
By the fourth week, most patients have completed the initial six infusions and are entering an evaluation phase. This is when your provider assesses your response, discusses what you have noticed, and begins planning the maintenance schedule that makes sense for your situation. That conversation is collaborative — your observations about how you are feeling, functioning, and sleeping are as relevant to the plan as any clinical measure.
For patients who have incorporated integration therapy alongside their infusions, week four often includes a reflection on what has shifted and what work remains. The two components — infusion and therapy — inform each other, and the maintenance plan may include continued psychotherapy sessions alongside periodic infusions depending on what has been most useful.
Addressing the Scheduling Barrier
We hear from many patients that the two-to-three-week infusion schedule is the piece of the treatment plan that requires the most logistical planning. Each infusion appointment requires a ride — driving is not permitted for twelve to twenty-four hours after treatment — and the first appointment requires nearly two hours of time. Our clinic is open Tuesday through Thursday during standard hours, with Monday and Friday appointments available on a by-appointment basis.
We recommend working out the scheduling logistics before your intake appointment rather than after. Knowing that rides are arranged for all six sessions, and that your work schedule can accommodate the recovery window, removes one significant source of stress from the early weeks of treatment. Our front desk team is glad to help you think through the timing before you commit to a start date.
Addressing Cost Transparency
The out-of-pocket cost of the initial six-infusion series is $3,000, based on the per-infusion rate of $500. Most insurance plans do not cover IV ketamine infusions because the treatment is used off-label for psychiatric conditions — meaning it is not FDA-approved for mental health indications, though clinical evidence supporting its use continues to grow. Most HSA and FSA accounts can be used as a form of payment, which provides a tax-advantaged option for many patients. We accept cash, credit and debit cards, and checks made out to MKW-Institute. For patients who qualify, a $250 service discount is available for military personnel, law enforcement officers, and front-line workers. You can also review our medication management services if your care involves coordinating psychiatric medications alongside ketamine treatment.
Frequently Asked Questions
How quickly will I notice results from ketamine therapy? The timeline varies considerably by individual. Some patients notice changes within hours of their first or second infusion; others see gradual shifts across the full six-session series. Research confirms that ketamine can produce rapid antidepressant effects, often within hours, but that cumulative benefit from repeated sessions is meaningful and builds over time. Discussing your specific expectations with your provider at intake helps calibrate realistic benchmarks for your situation.
What if I don’t respond to the first infusion? A single infusion is rarely the full picture. The protocol is six sessions for a reason — the cumulative neurological effect of repeated infusions is part of how the treatment works. If you have concerns about your response at any point during the series, those conversations happen with your provider in real time, not after the series is complete.
Can I work during the first month of treatment? Most patients return to normal activities, including work, the day after each infusion. The day of each infusion requires a ride home and a recovery period, and driving is restricted for twelve to twenty-four hours post-treatment. Planning infusion days on afternoons or days with flexibility tends to make the schedule more manageable.
Is integration therapy required alongside infusions? It is not required, but it is available and many patients find it meaningfully valuable. Our licensed therapists offer preparation and integration sessions separately from infusions. Research suggests that combining psychotherapy with ketamine treatment may support more durable outcomes than infusions alone, though individual results vary. Discuss whether this component makes sense for your situation at your intake consultation.
What happens after the sixth infusion? The sixth infusion transitions you into an evaluation and maintenance planning phase. Your provider will assess your response and recommend a maintenance schedule — typically one infusion every two to eight weeks — tailored to how you have responded. Maintenance infusions are $400 per session.
Key Takeaways
- The standard first month includes six infusions over two to three weeks, followed by evaluation and the start of a maintenance plan; results vary by individual.
- Cumulative benefit builds across the series — most patients notice more meaningful shifts by the middle and later infusions than after the first session alone.
- Scheduling logistics, including rides to and from every appointment, are worth planning before the intake visit rather than after.
- Integration psychotherapy sessions are available at our clinic as a separate, complementary component for patients who want to combine medicine and therapy.
- The transition after the sixth infusion is to maintenance care, not to discharge; ongoing infusions every two to eight weeks help extend the benefits of the initial series.
The first month of ketamine treatment is, for most patients, unlike anything they have experienced in prior mental health care — faster in some ways, more experiential in others, and more collaborative throughout. At Minnesota Ketamine & Wellness Institute, our team is present at every step, from the intake assessment through the sixth infusion and into the maintenance conversation that follows. Call us at 612-502-2800 or complete the consultation form on our website to talk through whether this treatment and timeline are a fit for where you are right now.
References
- American Journal of Psychiatry. Single, repeated, and maintenance ketamine infusions for treatment-resistant depression. https://psychiatryonline.org/doi/10.1176/appi.ajp.2018.18070834
- National Institutes of Health. Repeated ketamine sessions produce cumulative antidepressant benefits. https://pmc.ncbi.nlm.nih.gov/articles/PMC6236511/
- National Institutes of Health. Ketamine promotes neuroplasticity. https://pmc.ncbi.nlm.nih.gov/articles/PMC8190578/
Medical Disclaimer: The information in this blog is provided for educational purposes only and does not constitute medical advice. Ketamine infusion therapy at Minnesota Ketamine & Wellness Institute should only be pursued under the supervision of a licensed provider familiar with your complete medical and psychiatric history. Individual results vary, including the timeline and degree of symptom relief experienced during and after the initial infusion series. This content is not a substitute for a clinical evaluation or individualized treatment planning. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline or go to your nearest emergency room.