Most people researching ketamine therapy are not asking whether it works in general — they are asking whether it will work for them specifically, and whether they are even eligible to try it. That is a more useful question, and it deserves a direct answer. At Scottsdale Ketamine Clinic, we conduct thorough intake evaluations for exactly this reason: candidacy is not a checkbox, it is a clinical judgment built around your individual history.
What “Treatment-Resistant” Actually Means
Ketamine therapy was not designed as a first-line option. It is best understood as a treatment for patients whose conditions have not responded adequately to the standard approaches — a profile clinicians refer to as treatment-resistant. For depression, that threshold is generally defined as inadequate response to two or more antidepressants at therapeutic doses, taken for a sufficient duration (National Center for Biotechnology Information). For chronic pain conditions, it applies to patients whose pain has persisted despite conventional pharmacological management, physical therapy, or interventional procedures.
This distinction matters because it shapes who is most likely to benefit. Patients who have tried one medication for a short period and found it unhelpful have not yet reached the treatment-resistant threshold in the clinical sense. Patients who have completed multiple treatment trials, each at adequate doses and durations, and continue to struggle — that is the population ketamine therapy was specifically developed to serve.
At our Scottsdale and Phoenix locations, we treat both the mental health and chronic pain presentations of treatment resistance. That includes depression, anxiety, PTSD, OCD, and addiction on the mental health side, and CRPS, fibromyalgia, chronic migraines, and neuropathic pain on the chronic pain management side.
Mental Health Candidacy: Who We Work With
For patients seeking ketamine for mental health conditions, the clearest candidates are those who have not found adequate relief through antidepressants, therapy, or both. Research shows that ketamine produces rapid and significant antidepressant effects in patients who have not responded to prior medications — a population that conventional psychiatry has historically had limited options to offer (National Center for Biotechnology Information).
If you have treatment-resistant depression, you may be a good candidate if you have completed multiple antidepressant trials at appropriate doses, if your depression significantly impairs your functioning, and if you do not have contraindications that would make ketamine unsafe for you. Similar criteria apply to treatment-resistant anxiety, PTSD, and OCD.
For patients managing addiction, ketamine may help reduce cravings and address the underlying emotional patterns tied to substance use — but it is one component of a broader recovery approach, not a standalone cure. Patients pursuing ketamine for addiction recovery should be doing so as part of a larger, supervised treatment plan.
There are also psychiatric presentations where ketamine requires additional caution or may not be appropriate at all. Active psychosis, certain bipolar presentations, and uncontrolled cardiovascular conditions are among the factors our team evaluates carefully before recommending treatment. This is why the intake evaluation is thorough — not to create barriers, but to ensure that the patients we treat are genuinely positioned to benefit and to do so safely.
Chronic Pain Candidacy: A Different Evaluation
For chronic pain patients, candidacy assessment focuses on the nature and mechanism of your pain rather than a medication trial history in the traditional psychiatric sense. Conditions involving central sensitization — where the nervous system becomes hypersensitive to pain signals — tend to respond well to ketamine’s NMDA receptor blockade because that mechanism directly interrupts the amplified pain signaling at its source (National Center for Biotechnology Information).
CRPS (Complex Regional Pain Syndrome), fibromyalgia, neuropathic pain, and chronic migraines all fall into this category. If your pain has been documented and you have tried standard treatment approaches without adequate relief, that history is relevant to our evaluation. We review the full arc of what you have tried, for how long, and what the outcomes were.
For pain patients, some of the same medical considerations apply: cardiovascular status, history of dissociative disorders, substance use history, and the use of certain medications are all factors that inform whether ketamine is safe and appropriate for your specific situation.
Who May Not Be a Good Candidate
Being clear about who may not benefit is part of responsible candidacy assessment, and it is one of the things patients tell us they appreciate about our intake process.
Patients with active, uncontrolled psychosis are generally not candidates. Ketamine’s dissociative properties can worsen psychotic symptoms in vulnerable individuals, and the screening process is specifically designed to identify this risk. Similarly, patients with a history of ketamine misuse or who are actively struggling with substance use disorders that are not being addressed through a supervised recovery program require additional evaluation before we would consider infusion treatment.
Patients with significant uncontrolled hypertension, certain cardiac arrhythmias, or other cardiovascular conditions may need medical clearance from their primary care provider or cardiologist before treatment is appropriate. This is a clinical safeguard, not a permanent barrier — many patients with managed cardiovascular conditions proceed without issue after clearance.
Pregnancy is another contraindication. If you are pregnant or actively trying to become pregnant, ketamine infusion therapy is not appropriate at this time.
The Evaluation Process at Our Clinic
When you come in for a consultation at Scottsdale Ketamine Clinic, the evaluation is a genuine clinical conversation, not a sales encounter. We review your complete medical and psychiatric history, the full list of treatments you have tried and how you responded, your current medications, and your goals for treatment. Our team — led by Jenice Hughes, CRNA, a board-certified nurse anesthetist with more than four decades of clinical experience — uses that information to make an individualized recommendation.
If ketamine therapy is not the right fit for where you are clinically right now, we will tell you that directly. We would rather have that conversation than put a patient through a treatment course that is unlikely to serve them. Results vary by individual, and our commitment is to honest assessment rather than broad acceptance.
If you are a candidate, we build a personalized treatment plan and walk you through what to expect before you commit to anything — including the financial realities of treatment. IV ketamine infusions are not typically covered by insurance for mental health or pain conditions. We provide documentation for patients pursuing out-of-network reimbursement, and our front desk team covers the cost conversation fully before treatment begins. Our ketamine FAQs page is also a useful resource as you prepare your questions for the consultation.
A Note for Patients Who Are Unsure
The most common response we get from patients at the beginning of a consultation is some version of “I didn’t know if I was even eligible to call.” If that describes you, you were right to call. The intake evaluation exists to answer that question, and it is free. You do not need to arrive with a certainty about whether ketamine is right for you — that is what the evaluation determines. Explore your options with your provider and let the clinical picture guide the recommendation.
Frequently Asked Questions
Do I have to have tried a specific number of medications to qualify? The general clinical threshold for treatment-resistant depression is two or more antidepressant trials at therapeutic doses for adequate duration. For other conditions, the threshold varies. The intake evaluation looks at your full treatment history, not a specific number. If you are unsure whether your prior trials meet the threshold, that is exactly what the consultation is designed to clarify.
Can I pursue ketamine therapy if I’m currently on antidepressants or other psychiatric medications? Many patients who begin ketamine therapy are currently on psychiatric medications. Whether you continue those medications during a ketamine course depends on your individual situation. Some combinations are straightforward; others require more careful review. We assess this during intake and make individualized recommendations — we do not apply a uniform rule.
What if I have a history of substance use? Substance use history is one of the factors we evaluate, but it does not automatically disqualify a patient. The nature, timeline, and current status of substance use are all relevant. Patients in active, supervised recovery programs who are pursuing ketamine for addiction support or co-occurring mental health conditions are evaluated on the full clinical picture. Discuss your history honestly during the consultation — it helps us give you an accurate answer.
Is there an age minimum or maximum for ketamine therapy? We treat adult patients. Age alone is rarely a barrier, but overall health status, cardiovascular function, and the full medical history are all relevant to the evaluation. Older patients with managed medical conditions often proceed without issue after appropriate screening.
How long does the consultation take? Most initial consultations run 30 to 60 minutes. We cover your medical and psychiatric history, your treatment history, your goals, and what a treatment plan would look like if you are a candidate. There is no obligation to proceed, and the consultation is free.
Key Takeaways
- Ketamine therapy is specifically designed for patients who have not responded adequately to standard treatments — the treatment-resistant population — across both mental health and chronic pain conditions.
- At Scottsdale Ketamine Clinic, qualifying conditions include depression, anxiety, PTSD, OCD, addiction, CRPS, fibromyalgia, chronic migraines, and neuropathic pain.
- Absolute contraindications include active uncontrolled psychosis, pregnancy, and active unmanaged cardiovascular conditions; other factors require careful review rather than automatic exclusion.
- The intake evaluation is a clinical conversation, not a formality — it is designed to produce an honest, individualized answer about whether ketamine is appropriate for you.
- IV ketamine infusions are not typically covered by insurance; documentation for out-of-network reimbursement is available, and cost is discussed fully before treatment begins.
The candidacy question is worth asking directly, and it is worth asking of a team that will give you a straight answer. If you are living with a mental health condition or chronic pain that has not responded to the standard approaches, a consultation at Scottsdale Ketamine Clinic is a reasonable starting point. Call our Scottsdale location at 480-613-3226 or our Phoenix clinic at 480-590-6154 to schedule your free evaluation. Results vary by individual, but the evaluation itself is a no-obligation conversation — and knowing where you stand is worth having.
References
National Center for Biotechnology Information. Antidepressant Efficacy in Treatment-Resistant Depression. https://pubmed.ncbi.nlm.nih.gov/23982301/
National Center for Biotechnology Information. Ketamine for Chronic Pain. https://www.ncbi.nlm.nih.gov/books/NBK539824/
National Institutes of Health. Side Effects Mild and Brief from Single Antidepressant Dose of Intravenous Ketamine. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Whether IV ketamine therapy is appropriate for any individual can only be determined through a thorough evaluation by a licensed medical provider familiar with that person’s complete medical and psychiatric history. Individual results vary. Not all patients are candidates for ketamine therapy. 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.
