When to Consider Ketamine for Depression: A New Option for Treatment-Resistant Cases

You’ve tried multiple antidepressants. You’ve committed to therapy. You’ve given treatment after treatment months or even years to work. Yet depression still holds you back from living the life you want. If this sounds familiar, you’re not alone—and you haven’t run out of options.

For Houston area residents struggling with treatment-resistant depression, IV ketamine therapy represents a fundamentally different approach to healing. Unlike traditional antidepressants that can take weeks or months to show effects, ketamine often provides relief within hours or days. At Cura Mind and Wellness, we offer carefully monitored ketamine infusions in Richmond, helping patients across the Houston metro find breakthrough relief when standard treatments haven’t been enough.

Understanding Treatment-Resistant Depression

Treatment-resistant depression isn’t about failing at recovery or not trying hard enough. It’s a clinical reality affecting approximately one-third of people with major depression. Research indicates that after two adequate trials of antidepressants, the likelihood of remission with another traditional medication drops significantly.

This resistance happens for multiple reasons. Your brain chemistry may not respond to the serotonin or norepinephrine pathways that standard antidepressants target. Genetic factors might affect how you metabolize medications. Co-occurring conditions like anxiety, trauma, or chronic pain can complicate treatment. Sometimes, the right approach simply hasn’t been found yet.

When depression persists despite genuine effort and multiple treatment attempts, it’s not a personal failure—it’s a signal that your brain needs a different kind of intervention. That’s where ketamine comes in.

How Ketamine Works Differently

Unlike conventional antidepressants that primarily target serotonin, ketamine works through glutamate pathways in your brain. Glutamate is the most abundant neurotransmitter in your nervous system and plays a crucial role in neural activation and synaptic plasticity—your brain’s ability to form new connections and pathways.

When administered through carefully controlled IV infusion, ketamine rapidly increases synaptic activity in brain regions that regulate mood and cognition. Studies show that approximately 70% of patients with treatment-resistant depression experience significant improvement with ketamine therapy. This is remarkable compared to the roughly 30% response rate typically seen when trying yet another traditional antidepressant after multiple failures.

The speed of ketamine’s effects is equally striking. Many patients report reduced suicidal thinking, lighter mood, and improved ability to engage with therapy within days—sometimes even hours—after early infusions. This rapid action can be life-changing for someone who’s been waiting months between medication trials, watching their life slip by while hoping the next pill will finally work.

Ketamine also appears to promote neuroplasticity, helping your brain create new neural pathways. This is why integrating ketamine with therapy can be so powerful—the treatment creates a window of opportunity where your brain is more receptive to forming new patterns of thinking and emotional regulation.

Signs You Might Be a Candidate for Ketamine Therapy

Ketamine isn’t a first-line treatment for depression, but it can be transformative for the right patients. You might be a candidate for IV ketamine therapy if you’re experiencing any of these situations.

• Multiple Medication Failures: If you’ve tried two or more antidepressants at adequate doses for sufficient duration without achieving meaningful relief, treatment-resistant depression may be at play. Ketamine offers a different mechanism of action that could break through where other medications haven’t.
• Persistent Symptoms Limiting Function: When depression continues to significantly impact your ability to work, maintain relationships, care for yourself, or engage in daily activities despite treatment, more aggressive intervention may be warranted. Ketamine can provide rapid relief that helps you regain functioning quickly.
• Severe Episodes with Suicidal Thoughts: For patients experiencing severe depressive episodes accompanied by suicidal ideation, the rapid-acting nature of ketamine can be particularly valuable. Traditional antidepressants take weeks to work—time that feels impossible when you’re in crisis. Ketamine’s quick onset can provide crucial relief during dangerous periods.
• Side Effects Limiting Treatment Options: Some people experience intolerable side effects from multiple classes of antidepressants, leaving few traditional options. Ketamine’s different mechanism and administration method may be better tolerated.
• Co-Existing Anxiety or Trauma: Depression rarely exists in isolation. If you’re also struggling with anxiety disorders or trauma-related symptoms that haven’t responded to standard treatment, ketamine has shown promise for these co-occurring conditions as well.
• Need for Faster Results: Sometimes life circumstances require faster relief than traditional medications can provide. Whether it’s maintaining employment, caring for family, or preventing hospitalization, ketamine’s rapid action can make the difference between holding your life together and losing ground.

What to Expect from IV Ketamine Treatment in Richmond

At Cura Mind and Wellness, ketamine therapy follows a structured, medically supervised protocol designed to maximize safety and effectiveness. Led by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, a board-certified psychiatric mental health nurse practitioner with extensive experience in complex mood disorders, your care is overseen by an expert who understands both the promise and the limitations of this treatment.

• Initial Consultation: Your journey begins with a comprehensive evaluation to determine whether ketamine is appropriate for your situation. We review your diagnostic history, previous treatments, current medications, and medical conditions. Not everyone is a candidate—factors like uncontrolled hypertension, significant cardiac issues, active substance misuse, pregnancy, or certain psychotic disorders may require caution or rule out treatment entirely.
• The Infusion Series: Most patients complete an acute series of infusions over several weeks. Each IV infusion lasts approximately 40 to 60 minutes in our Richmond location, which is convenient to Sugar Land, Katy, Missouri City, and Fort Bend County. During the infusion, you’re continuously monitored for blood pressure, heart rate, oxygen saturation, comfort, and mental status.
• What It Feels Like: Many people feel relaxed or slightly detached during the infusion. Some notice brief changes in perception—this dissociative effect is normal and typically resolves shortly after the infusion ends. A clinician remains present throughout, and any uncomfortable side effects like nausea, dizziness, or lightheadedness are managed promptly.
• After the Infusion: You’ll need a responsible adult to drive you home, and we recommend resting for the remainder of the day. Most people resume normal activities the next day. We provide clear aftercare instructions, including hydration guidelines, red flags to watch for, and scheduled follow-up appointments.
• Tracking Progress: We measure your mood, sleep, energy, and daily functioning throughout the series using brief assessment tools. Many patients notice shifts by the second or third session, while others experience more gradual improvement. If you’re not responding as expected, we adjust timing or dosing within safe ranges, or pause to reassess the approach.

Integrating Ketamine with Comprehensive Care

Ketamine isn’t a standalone solution—it works best as part of a comprehensive treatment plan. At Cura Mind and Wellness, we coordinate your ketamine therapy with ongoing psychotherapy, medication management, and behavioral strategies to help improvements last.

• Therapy Enhancement: The neuroplasticity that ketamine promotes creates an ideal window for therapy. Many patients schedule therapy sessions shortly after infusions to capitalize on this heightened receptivity to change. Cognitive-behavioral techniques, trauma-informed approaches, and behavioral activation strategies become more effective when your brain is primed to form new patterns.
• Medication Adjustments: Your existing psychiatric medications may be continued, adjusted, or simplified based on your response to ketamine. We coordinate these changes carefully, always explaining the rationale and monitoring for safety.
• Maintenance Planning: If the initial series produces meaningful benefit, we develop a maintenance plan tailored to your needs. This might include less frequent infusions, transition to other treatment modalities, or integration of additional supports. The goal is sustained improvement that allows you to return to work, relationships, and daily routines with confidence and stability.

Realistic Expectations and Long-Term Outcomes

While ketamine’s rapid effects can feel miraculous after years of treatment resistance, it’s important to maintain realistic expectations. Responses vary significantly between individuals. Some Houston patients experience dramatic relief within 24 to 72 hours, with improved sleep and reduced hopelessness. Others notice more gradual gains throughout the series.

Ketamine typically doesn’t cure depression permanently on its own. Many patients maintain improvement for weeks to months after an acute series, but maintenance infusions or ongoing therapy are often necessary to extend benefits. Success with ketamine looks different for different people—for some, it’s complete remission of symptoms; for others, it’s enough improvement to engage meaningfully with therapy and rebuild their lives.

The key is approaching ketamine as one tool in your recovery toolkit, not a magic bullet. Combined with therapy, lifestyle changes, social support, and continued psychiatric care, ketamine can catalyze the kind of breakthrough that makes other healing work possible.

Safety and Monitoring in a Medical Setting

Ketamine therapy at Cura Mind and Wellness takes place in a licensed medical setting with rigorous safety protocols. Continuous monitoring, structured screening, and experienced oversight minimize risks. We screen carefully for contraindications, obtain informed consent, and ensure you understand both benefits and potential risks before beginning treatment.

In a controlled medical environment with appropriate dosing and monitoring, the risk of misuse is minimized. We do not provide ketamine therapy to patients with active substance misuse disorders, and we track your response closely throughout treatment.

Common side effects like nausea, dizziness, and temporary dissociation are typically mild and brief, resolving as the infusion ends. Serious complications are rare when treatment is administered by qualified professionals following evidence-based protocols.

Access Across Houston with Infusions in Richmond

While infusions occur at our Richmond location, most evaluations and follow-up appointments can be completed through secure telehealth anywhere in Houston. This hybrid approach reduces travel burden during the intensive treatment phase while maintaining the safety and precision that IV administration requires.

For Houston area residents who have tried everything else without success, this accessibility makes cutting-edge treatment available without excessive disruption to your daily life.

Start Your Ketamine Consultation Today

Led by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, Cura Mind and Wellness offers evidence-based ketamine therapy for treatment-resistant depression in a setting that prioritizes both safety and compassionate care. With experience in complex mood disorders and program leadership, Vivian provides the clinical expertise necessary to determine whether ketamine is right for you and to guide you through treatment with skill and understanding.

If standard treatments haven’t provided adequate relief, if you’re struggling with persistent symptoms that limit your life, or if you need faster results than traditional approaches can offer, ketamine therapy might be the breakthrough you’ve been seeking. Contact Cura Mind and Wellness today to schedule a consultation and learn whether IV ketamine treatment in Richmond is appropriate for your situation. When you’re ready to explore a new path forward, we’re here to help you evaluate the option with clarity, safety, and hope.