Ketamine Therapy in Sarasota: What to Expect Before, During, and After Treatment

Most patients considering ketamine therapy have done enough research to know it works faster than traditional antidepressants — sometimes within hours or days rather than weeks. What they usually do not know is what the experience actually involves from start to finish. That gap is where hesitation lives, and filling it is the point of this post.

Before Treatment: The Evaluation

Nothing at Cohen & Associates begins without a thorough psychiatric evaluation. This is not a formality. Ketamine-assisted psychotherapy is not appropriate for all patients, and determining candidacy requires understanding your full history — prior treatments, current medications, any medical conditions that could affect safety, and your specific psychiatric presentation.

Our evaluation process looks at whether your symptoms fit the profile for KAP: treatment-resistant depression, persistent anxiety, PTSD, or other conditions that have not responded adequately to standard approaches. We review what you have already tried, for how long, and how you responded. We also screen for any contraindications that would make ketamine treatment inadvisable.

This evaluation may be conducted by Dr. Rebecca Cohen, Dr. Robin Bixler, or Teri Callender — depending on your needs and availability. All three bring psychiatric expertise to the evaluation; Teri Callender additionally holds specific certification in ketamine-assisted psychotherapy (KAP), which informs the treatment planning for patients who move forward with KAP.

If you have been managing your mental health for years without finding lasting relief, the evaluation conversation can feel exposing. We approach it as a collaborative process. The goal is to understand your situation accurately enough to give you an honest answer about what your options are.

During Treatment: What Happens in a Session

Ketamine produces a temporary altered state — dissociative and, for many patients, emotionally expansive. This is not a side effect to be minimized; it is part of the therapeutic mechanism. Research confirms that ketamine’s action on NMDA receptors (specialized protein structures in the brain involved in learning and memory) produces rapid antidepressant effects in patients who have not responded to conventional treatments (National Institutes of Health). The altered state that accompanies it creates a window of neurological openness that structured psychotherapy is designed to work within.

In our KAP protocol, the ketamine component is followed by — or integrated with — therapeutic work led by Teri Callender. Patients are in a private, controlled setting throughout. You are not left to manage the experience alone, and the session is not simply a medication administration followed by a waiting room.

Side effects from a therapeutic dose of ketamine are typically mild and brief. The National Institutes of Health confirms that at clinical doses in supervised settings, the side effect profile is manageable and short-lived (National Institutes of Health). Most patients experience some degree of dissociation during the session, which resolves. Nausea is possible and can be addressed. You will need a ride home; driving after a ketamine session is not appropriate.

Ketamine acts rapidly — unlike SSRIs and SNRIs, which may take four to six weeks to produce measurable effects, ketamine often produces noticeable changes within hours to days of treatment (Nature/Translational Psychiatry). This rapid onset is one of the features that makes it particularly valuable for patients who are in significant distress and cannot wait weeks for relief to begin.

After Treatment: Integration

What happens after a session matters as much as what happens during it. The neuroplasticity window that ketamine opens does not stay open indefinitely, and how patients use the period following treatment affects whether the benefits hold.

Integration — the process of working through the material, insights, and emotional shifts that emerge during treatment — is built into our KAP approach. This is not something you are expected to manage independently at home. Teri Callender works with patients through this phase, and individual psychotherapy sessions with our team can continue as part of your broader treatment plan.

For patients who are also working with Dr. Cohen or Dr. Bixler on medication management, KAP fits within a coordinated care approach. We are not a standalone ketamine provider operating outside your broader psychiatric care — we are a full-service interventional psychiatry practice, and your KAP experience connects to the larger treatment relationship.

Results vary by individual. Some patients experience significant, durable relief after a KAP course. Others may need ongoing or maintenance sessions. We discuss realistic expectations for your specific situation during the evaluation and throughout treatment.

A Note on SPRAVATO®

We also offer SPRAVATO® (esketamine nasal spray), the FDA-approved treatment specifically indicated for treatment-resistant depression in adults. SPRAVATO® is administered in our office under medical supervision and involves a different protocol than KAP. For patients whose primary concern is treatment-resistant depression and who are interested in an FDA-approved nasal spray option, SPRAVATO® may be more appropriate than KAP. Our team can clarify the distinctions during your evaluation.

Addressing the Practical Questions

The cost of ketamine-assisted psychotherapy is something we discuss directly before treatment begins. We operate on a direct-care model — we do not bill insurance and do not accept insurance payments at the time of service. Patients pay by debit/credit card, check, or cash, and may be eligible for partial reimbursement through their insurance as out-of-network care. We provide invoices for that process on request.

We do not list specific pricing for KAP on our website, because the treatment plan and associated costs vary by patient. What we commit to is a transparent conversation about costs before you commit to anything.

Scheduling works through a direct call to our office. In-person appointments are available Monday through Friday at our Sarasota location, and telehealth is available for appropriate aspects of care.

FAQ

How long does a KAP session last?

Session length varies by protocol and individual treatment plan. This is something we discuss and confirm before treatment begins. Our team will give you a clear picture of what to expect time-wise so you can plan accordingly.

Do I need to stop my current medications before starting KAP?

Not necessarily. Whether and how to adjust current medications is a clinical decision made during your evaluation, based on your specific history and medication profile. Some patients continue existing medications alongside KAP; others make changes under medical supervision.

How many KAP sessions will I need?

There is no universal answer. The number of sessions depends on your presentation, how you respond to initial treatment, and your treatment goals. We outline a realistic plan during the evaluation and adjust as your care progresses.

Can I use ketamine therapy if I have a history of substance use?

A history of substance use is part of what we assess during the psychiatric evaluation. It does not automatically disqualify someone from KAP, but it is a factor that requires careful review. Discuss your history openly during the evaluation — complete information produces better clinical decisions.

Is ketamine therapy appropriate for adolescents?

Our KAP program is designed for adults. Our TMS program does have an FDA-cleared adolescent indication for major depressive disorder (ages 15–21). If you are seeking treatment for a minor, we can discuss appropriate options during a consultation.

Key Takeaways

• Every KAP patient at Cohen & Associates begins with a comprehensive psychiatric evaluation — candidacy is determined individually, not assumed.
• Ketamine works through the glutamate system via NMDA receptor activity, producing rapid antidepressant effects that differ mechanistically from traditional medications.
• The altered state produced by ketamine is not incidental — it creates a neuroplasticity window that our KAP protocol uses through structured psychotherapy.
• Side effects from therapeutic doses are typically mild and brief; patients need a driver after sessions.
• Integration work after sessions is built into our approach — the therapeutic relationship does not end when the session does.

Knowing what to expect removes one of the biggest barriers to getting the care you actually need. At Cohen & Associates, we will walk you through the full picture during your evaluation — no assumptions, no pressure. Call 941-559-8500 or use our online contact form to schedule your new patient consultation.

References

1. National Institutes of Health. Side effects from a single antidepressant dose of intravenous ketamine. https://www.nih.gov/news-events/news-releases/side-effects-mild-brief-single-antidepressant-dose-intravenous-ketamine
2. National Institutes of Health. Antidepressant efficacy of ketamine in treatment-resistant depression. https://pubmed.ncbi.nlm.nih.gov/23982301/
3. Nature/Translational Psychiatry. Acute cognitive effects of single-dose intravenous ketamine in major depressive disorder and PTSD. https://www.nature.com/articles/s41398-021-01327-5
4. Johns Hopkins Bloomberg School of Public Health. History and medical use of ketamine. https://publichealth.jhu.edu/2024/what-to-know-about-ketamine

Medical Disclaimer
The information in this blog is for educational purposes only and does not constitute medical advice. Ketamine-assisted psychotherapy and other advanced psychiatric treatments should only be pursued under the supervision of a licensed psychiatric provider familiar with your full medical and psychiatric history. Individual results vary. SPRAVATO® is a prescription medication available only through certified healthcare settings. 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.