Ketamine therapy for anxiety

What the evidence says

Small trials report reduced generalized and social anxiety symptoms for days to weeks after ketamine, and several ketamine clinics treat anxiety off label. The evidence is thinner and less consistent than for depression, and no guideline recommends ketamine as a first-line or second-line anxiety treatment. See the coverage hub, the ketamine therapy hub, and the coverage checker.

Who might consider it

Adults with severe, treatment-resistant anxiety, most often with co-occurring depression, who have completed a trial of evidence-based psychotherapy and two or more medications. Clinics should measure anxiety with a rating scale (GAD-7) and stop if there is no response.

What treatment looks like

Six infusions or a KAP program with therapy. Anxiety during the dissociative phase is common; preparation and a calm setting matter more here than in depression treatment.

Coverage and cost

Not covered. Cash prices run $350 to $850 per session. See ketamine clinics by state and side effects and safety.