Interventional psychiatry across Greater Seattle: at-home ketamine available now, with SPRAVATO® and TMS coming soon. Call or text 425-598-7088.
Interventional psychiatry across Greater Seattle: at-home ketamine available now, with SPRAVATO® and TMS coming soon. Call or text 425-598-7088.
Treatment-resistant depression can make every day feel like you’re moving through fog, disconnected from life and the people around you. When multiple antidepressant trials have failed to provide relief, the message you often hear is to keep trying different medications, waiting another six weeks to see if this one works better than the last. Ketamine offers a fundamentally different approach—working through a distinct mechanism that can produce improvements within hours to days, not weeks to months.
Nomad Therapeutics provides ketamine treatment for depression throughout Seattle, Tacoma, and South Seattle. Our registered nurses administer ketamine via intramuscular injection in your home or therapist’s office, eliminating the barriers of clinic visits while maintaining full medical oversight. This complete ketamine-assisted psychotherapy program combines rapid-acting medication with structured therapy to create lasting improvements rather than temporary symptom relief.
Depression that hasn’t responded to multiple treatment attempts requires more than another medication trial using the same mechanism. Nomad Therapeutics delivers ketamine treatment as part of a complete therapeutic framework designed specifically for treatment-resistant conditions.
Our at-home service model brings registered nurse-administered ketamine directly to your location in Seattle, Tacoma, and South Seattle. You receive the same medical protocols, safety monitoring, and clinical oversight used in traditional clinic settings, but in an environment you control. When depression makes leaving home feel overwhelming, at-home treatment removes that barrier while ensuring you get the medical supervision effective treatment requires.
What sets our approach apart is the integration of ketamine with psychotherapy from the beginning. The medication creates a neurobiological window where the rigid patterns maintaining your depression become more flexible. Structured therapy helps you use that window to develop new ways of thinking, feeling, and engaging with life. This combination produces improvements that last well beyond the medication’s acute effects.
Major depressive disorder involves persistent low mood, loss of interest or pleasure in activities, and a range of physical and cognitive symptoms that interfere with daily functioning. Treatment-resistant depression means you’ve tried at least two different antidepressant medications at adequate doses for sufficient duration without achieving adequate relief.
The experience of treatment-resistant depression goes beyond feeling sad. Many people describe it as emotional numbness—an inability to feel joy, connection, or hope. Concentration becomes difficult, making work or basic tasks feel impossible. Sleep patterns deteriorate, with some people sleeping far too much while others lie awake through the night. Energy evaporates. Simple decisions feel overwhelming. Physical symptoms accumulate: headaches, digestive problems, chronic pain.
The cycle becomes self-reinforcing. Depression makes it hard to do the things that might help you feel better—connecting with others, exercising, engaging in meaningful activities. The isolation deepens. Relationships strain under the weight of the illness. Financial problems may develop when depression makes it impossible to work consistently. For some people, thoughts of death or suicide emerge, not from a genuine desire to die but from desperate hope that the pain might end.
Traditional antidepressants work primarily on the serotonin system. When these medications don’t work after multiple trials, when therapy alone hasn’t been enough, finding treatments that work through different mechanisms becomes essential. Treatment-resistant depression isn’t a personal failure—it reflects the limitations of current first-line treatments and the need for alternatives targeting different neurobiological pathways.
Ketamine received FDA approval as an anesthetic in 1970 and has been used safely in medical settings for over five decades. In the early 2000s, researchers discovered that at sub-anesthetic doses, ketamine produced rapid antidepressant effects in people with treatment-resistant depression—improvements that appeared within hours rather than the weeks required by traditional antidepressants.
This discovery represented a paradigm shift in depression treatment. For the first time, researchers identified a medication that could produce rapid, robust antidepressant effects through a mechanism completely different from traditional approaches. Rather than targeting serotonin, ketamine acts on the glutamate system, which plays a crucial role in how brain cells communicate and form new connections.
Nomad Therapeutics administers ketamine via intramuscular injection. This route achieves 90-95% bioavailability, meaning nearly all of the medication reaches your brain to produce therapeutic effects. IM administration delivers effectiveness comparable to the intravenous infusions used in most clinical research, with the added convenience of receiving treatment at home rather than spending extended time in a clinic for IV infusion sessions.
Ketamine’s antidepressant effects involve multiple interconnected mechanisms. The medication acts on the glutamate system, helping quiet the overactive stress responses and negative thought patterns that characterize depression. Research shows that ketamine enhances the brain’s natural ability to form new neural connections and adapt existing patterns—a process that creates a window where rigid depressive thinking becomes more flexible.
During this window of increased neuroplasticity, patients often report being able to step back from the relentless negative thoughts and emotional numbness that characterize their depression. Some people describe accessing emotions they’ve been unable to feel for months or years. Others report gaining new perspectives on their lives and relationships. These shifts create opportunities for change that therapy can then build upon.
The timeline distinguishes ketamine from traditional antidepressants. While SSRIs typically require four to six weeks before producing noticeable effects, research shows that 64% of patients with treatment-resistant depression experience significant symptom reduction within 24 hours of a single ketamine treatment. This rapid onset provides crucial relief for people whose depression has become debilitating.
The combination with structured psychotherapy makes these rapid neurobiological changes translate into lasting improvements. The medication creates the opportunity for change, and therapy provides the framework for making those changes stick. Together, they produce sustained improvements in mood, functioning, and quality of life that persist well beyond the acute effects of the ketamine sessions themselves.
Treatment with Nomad Therapeutics begins with a free consultation where you can learn about ketamine-assisted psychotherapy and ask questions about whether it might help your specific situation. This conversation involves no commitment—just an opportunity to understand the treatment approach and determine if it makes sense to proceed.
If you decide to move forward, you’ll complete a clinical evaluation with a Nomad Therapeutics clinician. This appointment reviews your medical history, depression treatment history, current symptoms, and treatment goals. The evaluation determines whether ketamine treatment is medically safe and clinically appropriate for you. Not everyone qualifies, and this careful screening ensures that ketamine makes sense for your specific presentation.
Our standard protocol follows the regimen supported by clinical research: six ketamine sessions administered over three weeks. This schedule provides enough repetition for meaningful change while maintaining treatment intensity that prevents long gaps between sessions where depressive symptoms might return to baseline.
Each treatment cycle includes three integrated components. Before your ketamine session, you’ll work with your therapist in a preparation session. This meeting helps you set intentions for the upcoming experience and prepare mentally and emotionally for what might emerge. The preparation shapes what happens during the ketamine session and influences what insights or perspectives develop.
For the medication session, a registered nurse arrives at your chosen location in Seattle, Tacoma, or South Seattle with all necessary medical equipment. The session begins with checking your vital signs and centering on your treatment goals. The nurse administers ketamine via intramuscular injection, which takes just seconds.
Throughout the ketamine experience, which typically lasts one to two hours, the nurse monitors your vital signs at regular intervals and watches for any physical or psychological complications. You remain in your own space—your home or your therapist’s office—with a medical professional present the entire time. Our clinical team stays on standby throughout every session, available for consultation or emergency response if needed.
After the experience concludes, your nurse performs a final vitals check to ensure you’ve returned to baseline before leaving. You’ll then schedule integration therapy with your therapist to process what emerged during the session and identify concrete ways to bring insights into your daily life. This integration work transforms temporary neurobiological changes into lasting behavioral shifts that address the root causes of your depression.
Ketamine treatment works best for specific depression presentations. The strongest evidence supports its use for treatment-resistant depression—situations where you’ve tried at least two adequate trials of antidepressant medications without achieving sufficient relief. If multiple SSRIs or SNRIs haven’t worked, if you’ve engaged in therapy without adequate improvement, ketamine’s different mechanism of action may help where other treatments haven’t.
Research specifically demonstrates ketamine’s effectiveness in people whose depression hasn’t responded to conventional treatments. The 64% response rate in treatment-resistant populations suggests that ketamine can help many people for whom traditional approaches have failed. This makes it particularly valuable for people who’ve exhausted standard treatment options and need alternatives that work through different neurobiological pathways.
Ketamine also shows effectiveness for depression with significant anxiety symptoms, bipolar depression, and depression with suicidal ideation. The rapid onset makes it especially valuable for people experiencing acute suicidal thoughts, as the effects appear within hours rather than the weeks required by traditional antidepressants.
However, ketamine treatment isn’t appropriate for everyone. Certain medical conditions, particularly uncontrolled cardiovascular problems, may make ketamine unsafe. Active substance use disorders, especially involving dissociative drugs, typically preclude treatment. Pregnancy is a contraindication. The clinical evaluation process identifies these situations and determines whether ketamine represents a safe and appropriate option.
The decision requires consideration of your treatment history, current symptoms, and willingness to engage with the complete therapeutic process. Ketamine isn’t a quick fix that works in isolation. It requires commitment to preparation sessions, medication sessions, and integration therapy. For people with treatment-resistant depression who are willing to engage fully with this structured program, it offers genuine hope for the kind of meaningful improvement that has remained elusive with other treatments.
Safety and medical oversight remain central to every aspect of treatment. Each medication session involves a registered nurse providing active monitoring from beginning to end. Your nurse checks vital signs multiple times throughout the session, watches for complications, and responds immediately if concerns arise. This isn’t passive supervision—it’s engaged medical care delivered in the setting of your choice.
Our full clinical team backs every session, available for consultation or emergency response throughout your treatment. We maintain the same medical protocols whether treatment occurs in a clinic or your home. Emergency equipment, proper medication handling, sterile injection technique, and comprehensive monitoring all travel with our nurses to your location. The safety standards remain identical regardless of where the treatment takes place.
The at-home setting offers particular advantages for depression treatment. When depression makes even basic self-care feel impossible, mustering the energy to travel to a clinic, manage anxiety about medical settings, and coordinate transportation can create insurmountable barriers. At-home treatment eliminates these obstacles while maintaining the medical supervision that safe, effective treatment requires.
You control your environment during treatment—the lighting, temperature, music, and overall atmosphere. You can have meaningful objects nearby. You don’t need to manage depression symptoms in a clinical waiting room or worry about encountering other patients. This sense of control and comfort enhances the therapeutic process, making it easier to engage with whatever emerges during the ketamine experience.
Our approach positions ketamine treatment within a complete therapeutic framework rather than as standalone medication delivery. We coordinate medication sessions with your existing therapist or connect you with a ketamine-assisted psychotherapy specialist through the Nomad Network. This coordination ensures that preparation happens before each medication session and integration therapy follows afterward, creating the structure needed to translate temporary neurobiological shifts into lasting improvements in mood, functioning, and quality of life.
Treatment-resistant depression doesn’t mean you’ve exhausted all options. Ketamine-assisted psychotherapy offers a treatment approach that works through a different mechanism than traditional antidepressants, combined with structured therapy designed to create lasting change rather than temporary symptom relief.
Nomad Therapeutics brings this complete program to patients throughout Seattle, Tacoma, and South Seattle. Our at-home treatment model removes the barriers that make clinic visits difficult when depression has drained your energy and motivation, while maintaining the medical oversight and safety protocols that effective treatment requires.
We offer a free consultation to answer your questions and help you understand whether ketamine treatment might help your specific depression presentation. This conversation involves no pressure or commitment—just an opportunity to learn more and make an informed decision about whether this treatment approach makes sense for you.
Many patients notice significant improvement within 24 hours of their first ketamine session. Research shows that 64% of people with treatment-resistant depression experience meaningful symptom reduction within a day of treatment. However, the timeline varies between individuals. Some people experience immediate relief, while others see gradual improvement across the six-session protocol. The rapid onset distinguishes ketamine from traditional antidepressants, which typically require four to six weeks to show effects.
During the ketamine experience, you may feel dissociated or experience altered perceptions. These effects are temporary and resolve within hours of the session. Some people experience mild nausea, dizziness, or temporary increases in blood pressure during treatment. Our registered nurses monitor for these effects throughout each session. Serious side effects are rare when ketamine is administered by trained medical professionals with proper screening and monitoring protocols.
Our standard protocol involves six ketamine sessions over three weeks, a regimen supported by clinical research for producing meaningful improvement in treatment-resistant depression. Some patients may benefit from maintenance sessions after completing the initial protocol. The need for maintenance treatment depends on your individual response and will be discussed with your clinical team based on how you respond to the initial series.
Most people continue their existing antidepressant medications during ketamine treatment. The clinical evaluation reviews all your current medications to identify any that might interact with ketamine or affect treatment safety. You should never stop or change psychiatric medications without discussing the decision with your prescribing physician, as sudden discontinuation can cause withdrawal effects or symptom worsening.
Ketamine treatment works most effectively when integrated with ongoing psychotherapy, not as a replacement for it. The medication creates a temporary window of increased neuroplasticity, and therapy helps you use that window to develop new patterns of thinking and behaving. You’ll continue working with your therapist throughout treatment for preparation sessions before medication sessions and integration sessions afterward. This therapeutic framework makes the neurobiological changes ketamine produces translate into lasting improvements.
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No commitment — just a conversation about which intervention might be right for you. A Nomad Therapeutics representative will answer your questions and walk you through what to expect.
