Ketamine Therapy for Depression in Scottsdale

Depression is one of the most common mental health conditions in the world — and also one of the most undertreated. Standard first-line treatments, primarily SSRIs and SNRIs, work well for many patients. But research consistently shows that 30 to 40 percent of people with major depressive disorder do not achieve adequate relief from antidepressants, even after trying multiple medications at therapeutic doses.

This is what clinicians call treatment-resistant depression, or TRD. It is not a failure of willpower or character. It is a biological reality — one that reflects the heterogeneous nature of depression and the limitations of medications that target only the serotonin and norepinephrine systems. For patients with TRD, the search for relief can stretch across years and involve dozens of medication trials, augmentation strategies, and therapy modalities.

Ketamine offers something different: a mechanism that bypasses the serotonin system entirely and acts directly on glutamate receptors, which are involved in synaptic plasticity and the brain's ability to rewire itself. This is why ketamine can produce results when antidepressants have not.

Traditional antidepressants work by modulating monoamine neurotransmitters — serotonin, dopamine, and norepinephrine. Their effects build over weeks or months and require continuous daily dosing. Ketamine's mechanism is fundamentally different.

Ketamine acts primarily as an NMDA receptor antagonist, which triggers a cascade of effects in the glutamate system. This leads to rapid upregulation of BDNF (brain-derived neurotrophic factor) and activation of the mTOR pathway — both of which drive neuroplasticity. In practical terms, ketamine promotes the growth and strengthening of synaptic connections in regions of the brain that are typically atrophied in chronic depression.

The clinical result is often striking: many patients report meaningful improvements in mood, motivation, and cognitive flexibility within hours of their first infusion — a speed that no oral antidepressant can match. A full induction series of four to six sessions is designed to build and sustain those effects. Some patients also explore Spravato (esketamine), the FDA-approved nasal spray alternative for treatment-resistant depression.

Every patient at Innerbloom begins with a free physician intake — a one-on-one consultation with Dr. Andrew Zabel. This is a thorough clinical evaluation to determine whether ketamine is appropriate, to review your psychiatric and medical history, to assess your current medications, and to answer your questions honestly.

If you are a good candidate, the next step is typically an induction series of four to six IV ketamine infusions over two to three weeks. Each infusion lasts approximately 45 to 60 minutes and is monitored throughout by Dr. Zabel — not by nursing staff alone. This matters particularly for patients with complex medical histories or those on multiple medications.

Following the induction series, many patients benefit from integration support and optional membership for ongoing maintenance sessions. Pricing for the induction series ranges from $2,200 to $3,000. Single sessions are $625. Full details are on our pricing page.

Ketamine is a controlled substance and a dissociative anesthetic. It requires careful patient selection, individualized dosing, and real-time clinical judgment throughout each session. Dr. Zabel's background in board-certified Emergency Medicine means he has spent years managing IV medications, monitoring hemodynamic parameters, and making rapid clinical decisions under pressure. At Innerbloom, every infusion is physician-supervised from start to finish — a standard we believe every ketamine clinic should meet.

We also treat conditions that frequently co-occur with depression, including PTSD and anxiety. Many patients present with overlapping diagnoses, and Dr. Zabel evaluates the full clinical picture rather than treating each condition in isolation.