trellis
Patient information packet

Ketamine
Maintenance
Program.

A new path forward when nothing else has worked.

For patients with depression or anxiety that hasn't responded to standard medications. A structured, supervised program designed around your safety and your life.

01 — What this is

A different mechanism. A different result.

Ketamine is a medicine that's been used safely in hospitals since the 1970s. At small, carefully chosen doses, it has emerged as one of the most effective treatments we have for depression and anxiety that has not responded to traditional medications like Prozac or Zoloft. It works differently from those medicines — it helps your brain rebuild connections that depression has worn down. People often feel improvement within days, not weeks.

Our program combines the convenience of at-home dosing with the safety of in-clinic care. You'll be evaluated and supervised in person before any medicine is sent home. Every dose is monitored. Your safety is the framework.

02 — Here's how it works

Three phases, paced for your safety.

1

In-Person Evaluation

One visit · in our office

Dr. Rafiq evaluates your medical and mental health history, checks your blood pressure, and screens carefully to make sure this is the right treatment for you.

2

Supervised Induction

Two visits · in our office

You take your first doses here in our clinic, with your blood pressure monitored throughout. We confirm you respond well before any medicine goes home with you.

3

At-Home Maintenance

6–12 months · ongoing

Medicine is shipped to your home. You take it twice a week with a trusted adult present. Monthly video check-ins. In-person re-evaluation every 90 days.

03 — What you'll need

A peer monitor.

For your safety, every at-home dose must be taken with a trusted adult physically present in the room with you. We call this person your peer monitor — and they're one of the most important parts of what makes this program work.

Your peer monitor can be a spouse, parent, adult sibling, or a very close friend — anyone you trust completely. They must be at least 21 years old, sober during your session, and willing to commit to being with you for about 4 hours at a time. Before they're approved, they'll meet briefly with our team and sign a simple agreement explaining their role.

04 — Being honest with you

What to expect — and what to watch for.

Ketamine therapy is powerful, and like any powerful treatment, it comes with real considerations. We want you to know all of them before you decide.

You may experience
  • A relaxed, dreamy, or floaty feeling for an hour or two during each session — this is part of how the medicine works
  • Mild nausea or sleepiness afterward
  • A short-term rise in blood pressure during the session, which we monitor
You should not drive

On any day you take a dose. Plan to rest at home for the remainder of the day.

What we screen for

Not everyone is a good candidate. We do not enroll patients with uncontrolled high blood pressure, certain bipolar presentations, a history of psychosis, active substance use issues, current pregnancy, or a history of bladder problems. If any apply, we'll discuss other options together.

Important to know. The form of ketamine used in this program (a dissolving tablet) is not FDA-approved specifically for depression or anxiety. It is prescribed off-label, which is legal and supported by clinical research. The FDA has noted that at-home ketamine without medical oversight carries risks — our program is specifically designed to provide that oversight at every step.
05 — What it costs

Direct pay, no insurance billing.

Insurance does not cover this program. All payments are made directly. We accept all major credit cards, Stripe Link, Affirm, and Klarna for payment plans.

Initial in-person evaluation
$400
Supervised induction session (×2)
$400 each
Monthly maintenance fee
$300
Compounded medication (billed by pharmacy)
$100–200 / month
90-day in-person re-evaluation
$175

A typical patient invests about $1,200 in the first month and approximately $400–500 per month after that.

06 — Your next step

There's no pressure to decide today.

Take this page home. Talk to the person you're thinking of asking to be your peer monitor. Review the consent packet we've given you. When you're ready:

A note from Dr. Rafiq

Treatment-resistant depression and anxiety are real, and they are exhausting. If standard medications haven't worked for you, that's not a failure on your part — it's information we use to find the right path. This program is designed for people who deserve a better answer than "try another antidepressant." If it's right for you, I'll tell you. If it isn't, I'll tell you that too, and we'll find something that is.

— Dr. Faisal Rafiq