What Is IV Ketamine Therapy?

1 in 3 people are affected by depression, anxiety, and PTSD in some populations. Traditional treatments like medication and talk therapy can help, but up to 80% of patients experience side effects from antidepressants, and up to 80% don't respond adequately to conventional treatments. For patients with treatment-resistant depression, anxiety, or PTSD, IV ketamine infusion therapy offers a fundamentally different path.

At Clarus Health's ketamine clinic in San Francisco, IV ketamine therapy is a rapidly-acting, physician-supervised infusion treatment for depression, anxiety, PTSD, chronic pain, and other conditions where standard medications have fallen short. Ketamine has been used safely in medicine for over 50 years — and its power to promote neuroplasticity and rapidly relieve mental health symptoms has made it one of the most significant advances in psychiatry in decades.

Serving patients throughout the San Francisco Bay Area, Clarus Health takes a holistic, root-cause approach — pairing IV ketamine infusions with complementary therapies personalized to your biology, your genetics, and your history.

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How IV Ketamine Infusions Work

Unlike traditional antidepressants that target serotonin or norepinephrine, ketamine works on a fundamentally different pathway. It blocks the NMDA receptor in the brain, modulating glutamate — the brain's primary excitatory neurotransmitter. This activates the AMPA receptor and triggers mTOR signaling, catalyzing neuroplasticity: the brain's ability to form new connections and rewire away from entrenched patterns of pain and suffering.

A hallmark of depression and PTSD is cognitive rigidity — the brain becoming "stuck" in loops of rumination and hyperarousal. IV Ketamine induces cognitive flexibility by physically rewiring these stuck patterns. This is why a single IV ketamine infusion can produce relief within hours, not weeks — it does not simply mask symptoms, it creates the neurological conditions for lasting change.

This rewiring opens a "critical window" of neuroplasticity after each infusion — a period when the brain is most receptive to forming new, healthier patterns. Working with a therapist during this window can rapidly accelerate the gains from treatment.

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What Conditions Can IV Ketamine Therapy Treat?

IV Ketamine can provide rapid, sustained relief across a wide range of conditions driven by dysregulated brain chemistry, neuroinflammation, or an overactive stress response:

• Depression — including treatment-resistant depression; clinical evidence supports rapid antidepressant effects
• Anxiety — multiple studies show sustained relief from refractory anxiety; IV ketamine reduces hyperactive theta activity in the frontal lobe linked to anxiety
• PTSD — a leading treatment-resistant condition; ketamine promotes neuroplasticity fundamental to PTSD healing, rewiring hippocampal circuits where traumatic memories are improperly stored
• Chronic fatigue (ME/CFS) — affects nearly 2% of the population; ketamine's anti-inflammatory properties and microglial inhibition address the neuroinflammatory drivers of ME/CFS
• PMS and PMDD
• Postpartum depression
• Chronic pain, fibromyalgia, and migraines — clinical evidence for ketamine's rapid pain-relieving effects
• OCD
• Cognitive decline associated with depression and aging
• Traumatic brain injury (TBI)
• Addiction — in collaboration with an addiction specialist; research supports ketamine's role in disrupting addictive patterns

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Why IV Ketamine Infusions Outperform Lozenges, Nasal Sprays, and Shots

Not all ketamine is equal. The route of administration profoundly affects effectiveness, safety, and predictability. The IV route outperforms all others on every meaningful metric:

• 100% bioavailability — IV ketamine bypasses the gut entirely, delivering a precise, reliable dose every time. Oral ketamine has only ~30% bioavailability
• Faster relief — up to 2x faster than intranasal esketamine (Spravato), with superior results earlier in the treatment course
• Higher response rates — up to 79% response rate with IV ketamine, versus ~40% with nasal spray and ~30% with oral ketamine
• Precise, adjustable dosing — a physician titrates in real time. The doses needed for anxiety relief are sometimes higher than what can be reliably achieved orally
• More effective overall symptom relief, particularly compared to other formulations
• Safer supervision — at-home ketamine carries real risks; physician presence ensures continuous monitoring and immediate dose adjustment

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What to Expect at Our San Francisco IV Ketamine Clinic

At Clarus Health, your infusion experience is designed for comfort, safety, and therapeutic depth. A board-certified physician is present throughout every session.

1. Holistic intake Before your first infusion, Dr. Kaveh conducts a thorough evaluation — reviewing your mental health history, medications, genetics, hormones, and bloodwork. This includes exploring the role of past trauma and genetic predispositions in shaping your symptoms. Your protocol is built around your specific biology, not a generic template.
2. The infusion You recline comfortably in a private suite. IV ketamine is administered over approximately 45–60 minutes at a carefully calibrated dose. Many patients experience perceptual shifts, emotional processing, or a dreamlike state — all part of the therapeutic process, closely monitored by your physician.
3. The integration window The hours and days after each infusion open a critical window of neuroplasticity. Working with a therapist during this window can unlock profound new perspectives. Many patients report doing years of therapeutic work in just one or two post-infusion sessions.
4. Follow-up and optimization Dr. Kaveh calls after every infusion to check in and adjust your protocol as needed. Your experience is monitored across the full series, not just session by session.

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IV Ketamine Treatment: How Many Infusions, and How Long Does Relief Last?

Most patients complete an initial series of 6 infusions over 2–3 weeks. Many begin to feel a shift after the first or second session — positive changes can begin rapidly — with the full series producing the most durable results through cumulative neuroplastic change.

Relief typically lasts weeks to months. Booster infusions are available, but the majority of Clarus Health patients go more than 4 months between boosters. Duration of relief depends significantly on:

• Whether complementary therapies (SGB, NAD+, hormone optimization) are incorporated
• Engagement with a therapist during the neuroplastic integration window after each infusion
• Life circumstances and ongoing stress load
• Individual genetic and hormonal factors

Antidepressants carry their own long-term risks — including significant side effects and difficult withdrawal syndromes (Lancet). For many patients, a short series of IV Ketamine infusions with periodic boosters represents a more sustainable long-term path.

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Combining IV Ketamine Therapy with Other Treatments

Yes — and at Clarus Health, combination therapy is the rule, not the exception. IV Ketamine produces its most powerful and lasting results as part of a broader protocol addressing the root causes of your condition.

IV Ketamine + Stellate Ganglion Block (SGB)

SGB and IV Ketamine have powerful synergistic effects. Both support neuroplasticity and help reset a nervous system stuck in fight-or-flight. This combination is especially effective for treatment-resistant depression and PTSD, ME/CFS, chronic pain, and migraines.

IV Ketamine + NAD+

NAD+ supports cellular energy production and reduces neuroinflammation — addressing the mitochondrial and inflammatory drivers of fatigue and brain fog. Combined with IV Ketamine, NAD+ can accelerate recovery from fatigue, brain fog, and Long COVID, and extend the duration of ketamine's antidepressant effects.

IV Ketamine + Hormone Optimization

Hormonal imbalances — in thyroid, cortisol, estrogen, and testosterone — are a frequently overlooked driver of treatment-resistant depression. Optimizing hormones before and during ketamine treatment can substantially improve outcomes and the durability of relief. This is why advanced bloodwork and genomic testing are part of every Clarus Health intake.

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Is IV Ketamine Therapy Safe?

Ketamine has been used safely in medicine for over 50 years. When administered by a board-certified physician at therapeutic doses, serious adverse effects are rare. Common temporary effects during infusion — dissociation, altered perception, mild nausea — resolve quickly and are managed in real time by your physician.

Concerns about ketamine addiction risk are often raised but rarely applicable at the low doses and infrequent schedule used therapeutically. Unlike at-home protocols, IV ketamine under physician supervision provides the precision and oversight that makes the therapy both effective and responsible.

In patients with anxiety, relief is typically sustained — and even when symptoms partially return, they are not as severe as before treatment.

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Begin IV Ketamine Therapy in San Francisco

Whether you are struggling with treatment-resistant depression, PTSD, anxiety, chronic pain, or fatigue — and whether you have tried many medications or are exploring IV ketamine infusion therapy for the first time — Clarus Health's San Francisco ketamine clinic offers a path forward. Contact us for a free 15-minute consultation with Dr. Kaveh or Dr. Shrestha. We serve patients throughout the San Francisco Bay Area.

*The FDA has not approved intravenous ketamine for the treatment of any psychiatric or pain condition. This content references off-label use that has been practiced clinically for decades. Like all medical treatments, IV Ketamine carries risks and benefits that should be discussed with a physician. Speak with a doctor at Clarus Health to learn if this therapy may be right for you.