"Ketamine infusion therapy" is the umbrella term for delivering ketamine — a Health Canada-approved anaesthetic, used off-label for psychiatric indications — through a controlled clinical route while a patient rests in a monitored setting. The most-studied form is intravenous (IV) at 0.5 mg/kg over 40 minutes, but contemporary Canadian KAT (ketamine-assisted therapy) clinics also use intramuscular (IM) injection, sublingual (SL) lozenges, and intranasal Spravato. This article is the patient-friendly entry point: what an infusion actually involves, what to expect, how the routes differ, what it costs, and where ATMA CENA fits in. For the more clinical-technical IV-specific deep dive, see Intravenous Ketamine Therapy. For the Spravato-specific guide, see Intranasal Ketamine and Spravato.
Key takeaways
- "Ketamine infusion" most commonly refers to IV ketamine (0.5 mg/kg over 40 minutes, the protocol used in landmark RCTs from Zarate 2006 onward). Intramuscular, sublingual, and intranasal Spravato are alternative routes with different pharmacokinetics and access patterns.
- All routes are off-label except Spravato, which is Health Canada-approved for treatment-resistant MDD as of May 2020.
- ATMA CENA's corporate clinics in Edmonton and Calgary deliver KAT primarily via intramuscular and sublingual ketamine, not IV. Other Canadian providers (SABI Mind, Toronto Ketamine Clinic, Ontario Ketamine and Infusion Centre) operate IV-led models. The right route depends on indication, clinical fit, and access.
- A typical session is ~90–120 minutes total: vitals + IV start + dosing + observation + discharge with a designated driver.
- Provincial accreditation matters: IV ketamine in non-hospital settings requires CPSA / CPSO / CPSBC / CPSS facility accreditation in most provinces; IM, SL, and intranasal routes generally have lighter facility requirements.
What is a ketamine infusion?
A ketamine infusion is a clinical session in which sub-anaesthetic ketamine is delivered into your body in a monitored setting. The most-studied form is intravenous (IV): a small IV catheter is placed in your arm, ketamine at 0.5 mg/kg is mixed in saline, and the infusion runs over 40 minutes through a controlled pump. You are reclining or lying down throughout; vitals are monitored continuously; a clinician stays with you.
A few clarifications matter:
- "Infusion" is most precisely the IV route. In casual usage, "infusion therapy" sometimes refers to any in-clinic ketamine session.
- "Ketamine-assisted therapy (KAT)" or "ketamine-assisted psychotherapy (KAP)" is the broader treatment model — the infusion (or IM, or SL) plus structured preparation and integration psychotherapy around it.
- "Spravato" is intranasal esketamine — a different molecule (S-enantiomer only), Health Canada-approved for TRD, delivered as nasal spray with mandatory ≥2-hour observation.
How ketamine works
Ketamine acts on the brain's glutamate system through NMDA receptor antagonism, triggering a downstream surge of glutamate, AMPA receptor activation, and BDNF release that stimulates synaptogenesis — the formation of new neural connections within 24 to 72 hours of a dose (Aleksandrova et al., 2017; Lullau et al., 2023). Conventional antidepressants take 4 to 6 weeks to act; a single ketamine dose can produce antidepressant effects within 2 to 72 hours. The Canadian Network for Mood and Anxiety Treatments places IV racemic ketamine as a third-line treatment for adults with treatment-resistant depression (Swainson et al., 2021).
For the full mechanism breakdown, see What Is Ketamine Therapy?.
What to expect at a session — patient-friendly walkthrough
A typical KAT session runs 90 to 120 minutes total in clinic. Here is what most Canadian clinics structure:
Arrival and prep (~15 minutes). You check in, confirm you have a designated driver for after, sign session-day consent, and meet the clinician who will be with you. You reclined in a chair or bed; vitals are taken (blood pressure both arms, heart rate, oxygen saturation); for IV, an IV catheter is placed in your forearm. For IM, the injection is given to the upper arm or thigh. For SL, you are given a measured lozenge to hold under your tongue. For Spravato, you are guided through the nasal spray device. Your therapist or clinician sets the room — typically eye shades, music if you want it, and a quiet environment.
Dosing and active session (~40–90 minutes). For IV, the 40-minute infusion begins. Effects start within 5–10 minutes. Most patients describe a softening of body awareness, time distortion, and emotional opening. This is dissociation — it is the intended therapeutic effect, not a side effect. Peak experience is typically 20–30 minutes into an IV infusion. For IM, onset is similar (5–15 minutes) with the same peak. For SL, onset is 10–20 minutes and the experience is generally milder due to lower bioavailability (~30%). For Spravato, onset is 10–20 minutes after the spray, and the experience is somewhat milder than IV. Throughout, the clinician monitors vitals, provides grounding if needed, and stays present.
Recovery (~30–60 minutes). The acute experience subsides over 30–60 minutes. Vitals are rechecked. For Spravato, Health Canada requires ≥2 hours of post-dose observation. You stay in clinic until the team confirms you are stable.
Discharge. Your designated driver picks you up. You cannot drive for at least 24 hours. Most patients rest at home for the remainder of the day. Integration sessions follow within 24–72 hours.
For the experiential / dissociation side specifically, see Does Ketamine Therapy Get You High?.
How the routes compare
| Route | Bioavailability | Onset | In-clinic time | ATMA CENA offers? | Clinical setting |
|---|---|---|---|---|---|
| IV (intravenous) | ~100% | 1–5 min | ~90–120 min | Not at corporate clinics | CPSA/CPSO/CPSBC-accredited facility |
| IM (intramuscular) | ~93% | 5–15 min | ~75–105 min | Yes (corporate clinics) | Accredited facility (lighter req than IV in most provinces) |
| SL (sublingual) | ~25–30% | 10–20 min | ~60–90 min | Yes (corporate clinics) | Generally lighter facility req |
| Intranasal Spravato | ~48% | 10–20 min | ≥2 hours observation post-dose | Confirm at intake | Janssen Journey-certified clinic |
The honest practical summary: IV has the strongest evidence base because it is the route used in most landmark RCTs (Zarate 2006, Murrough 2013, Singh 2016, Phillips 2019, the ELEKT-D ketamine-vs-ECT 2023 trial). IM is highly bioavailable and operationally simpler — no IV access, shorter session footprint. SL is the most flexible — usable in many settings — but bioavailability is lower. Spravato is the only Health-Canada-approved psychiatric ketamine form and is the route most likely to have private insurance prior-auth coverage for documented TRD.
For the IV-specific clinical deep dive, see Intravenous Ketamine Therapy. For Spravato, see Intranasal Ketamine and Spravato.
What does it cost?
ATMA CENA's published KAT pricing applies across the network: KAT Psychedelic Pathway from CAD $1,585 + $795 per additional session; KAT Psycholytic Pathway from CAD $1,530 + $740 per additional session; customized programs CAD $2,325–$6,930. A non-refundable deposit of CAD $300 applies. ATMA CENA's pathways are KAP-model — the price includes preparation, dosing, and integration sessions, not just the dosing.
For a wider Canadian comparison:
| Provider type | Per-session cost (CAD) | Notes |
|---|---|---|
| ATMA CENA KAT (IM/SL via corporate clinics) | $740–$1,585 acute + integration bundled | Three-phase KAP model |
| IV-only clinic (e.g., Ontario Ketamine and Infusion Centre, Mississauga) | ~$375 | Infusion-only, no bundled psychotherapy |
| Toronto Ketamine Clinic IV bundle | ~$725 | 6-infusion bundle pricing |
| SABI Mind (Calgary, Saskatoon, Edmonton, Victoria) | Consultation-based pricing | Anesthesiology-led IV/IM |
| Spravato (private with prior auth) | ~$800–$900 per session | Often partially insurance-covered for documented TRD |
For the full Canadian pricing breakdown, see Ketamine Therapy Cost in Canada. For insurance navigation, see Insurance Coverage for Ketamine Therapy.
Where ATMA CENA fits
ATMA CENA's corporate clinics in Edmonton and Calgary deliver KAT primarily through intramuscular and sublingual ketamine in a structured three-phase model: preparation, dosing, integration. ATMA CENA is not an IV-led infusion clinic. The published rationale for this model emphasizes the value of bundled psychotherapy around dosing rather than infusion-only delivery. For patients whose clinical picture — for example, severe TRD where the largest published RCT base is in IV — points toward IV specifically, ATMA CENA intake call can route to a coordinated care arrangement with an IV-led provider or, where indicated, to Spravato.
For ATMA CENA's specific pathways and what's bundled, see ATMA CENA's Psychedelic-Assisted Therapy program.
Common patient questions
Will I be alone during the infusion? No. A clinician (nurse, physician, or both) stays with you throughout. In KAT models including ATMA CENA's, an integration therapist or KAT therapist typically attends as well. You are continuously monitored.
What if I get scared during the experience? Set and setting matter. Preparation sessions before the first dose review what the experience can feel like and how to ground yourself if anxiety arises. The clinician is trained in managing acute distress and dissociation. Most patients who report initial fear find that grounding techniques and clinician presence are sufficient. For some, a lower starting dose is appropriate; this is part of personalized intake.
Can I drive home after? No. Patients cannot drive for at least 24 hours after a session. You need a designated driver. Public transit, rideshare, or a trusted person are practical alternatives.
What if I'm afraid of needles? The IM and SL routes do not require IV access. The intake call discusses route options based on your indication, anatomy, and preference. Spravato (intranasal) avoids needles entirely.
Is it safe? At sub-anaesthetic supervised doses, ketamine has a well-characterized short-term safety profile (Murrough 2015 safety analysis; Wajs 2020 SUSTAIN-2 long-term safety for esketamine). Common transient side effects include mild nausea, brief blood pressure elevation, dizziness, and headache. Pre-treatment screening rules out absolute contraindications (active psychosis, uncontrolled hypertension, severe cardiovascular disease, active mania, current pregnancy). For the full safety picture, see Ketamine Therapy Side Effects.
How many sessions will I need? Most acute-course KAT protocols are 4–6 dosing sessions over 2–3 weeks, paired with preparation and integration psychotherapy. Maintenance varies from monthly to as-needed depending on response and indication. For more on this, see How Many Ketamine Treatments Do I Need?.
What's the difference between an infusion and KAT? "Infusion" is most precisely the IV route. KAT (ketamine-assisted therapy) is the broader treatment model — dosing plus structured preparation and integration psychotherapy around it. Most Canadian ketamine clinics are KAT-model; some IV-only clinics offer infusion without integrated psychotherapy.
Does insurance cover ketamine infusions? Generally no for off-label IV/IM/SL ketamine. Spravato is the form most likely to be privately covered with prior authorization for documented TRD. Workers' compensation pathways apply for compensable injuries (WSIB Ontario Psychotraumatic and Chronic Pain formularies; WCB Alberta CRPS and refractory neuropathic pain). VAC covers ketamine drug forms case-by-case for service-related TRD or chronic pain.
Sources
- ATMA CENA — Psychedelic-Assisted Therapy: https://psychedelic.healthcare/
- Zarate CA Jr, et al. (2006). Randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. https://pubmed.ncbi.nlm.nih.gov/16894061/
- Murrough JW, et al. (2013). Antidepressant efficacy of ketamine in TRD: a two-site randomized controlled trial. Am J Psychiatry. https://pubmed.ncbi.nlm.nih.gov/23982301/
- Swainson J, et al. (2021). CANMAT racemic ketamine task force recommendations. Can J Psychiatry. https://pubmed.ncbi.nlm.nih.gov/33174760/
- Aleksandrova LR, et al. (2017). Antidepressant mechanisms of ketamine. Can J Psychiatry. https://pubmed.ncbi.nlm.nih.gov/28234212/
- Lullau APM, et al. (2023). Antidepressant mechanisms of ketamine. Front Neurosci. https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1223145/full
- Anand A, et al. (2023). Ketamine versus ECT for nonpsychotic TRD: ELEKT-D. N Engl J Med. https://pubmed.ncbi.nlm.nih.gov/37224135/
- Health Canada DPD — Spravato: https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98903
- CPSA — Ketamine Clinical Toolkit: https://cpsa.ca/resources/ketamine-toolkit/
Related articles in this cluster
- Ketamine Therapy in Canada
- What Is Ketamine Therapy?
- Intravenous Ketamine Therapy
- Intranasal Ketamine and Spravato
- Group Ketamine Therapy
- Ketamine Therapy Side Effects
- Does Ketamine Therapy Get You High?
- Ketamine Therapy Cost in Canada
- Insurance Coverage for Ketamine Therapy
- How to Qualify for Ketamine Therapy in Canada
Last updated: 2026-05-06