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Condition · Depression

Ketamine therapy for depression in DC, Maryland & Virginia

Depression is the most common mood disorder, and experiencing it can feel intensely isolating even when you're surrounded by support. When antidepressants and traditional talk therapy fail to bring adequate relief, ketamine works on a different system in the brain — and can bring relief in weeks.

Book a free consult(301) 381-8381
A calm private infusion suite at an Avesta clinic
10+ yrsTreating patients in the DMV
4.9★Average Google rating
5Clinics across DC, MD & VA
1,000+Patients treated to date

Ketamine treats depression by rebalancing glutamate and GABA, the brain chemicals that regulate mood, thought and emotional processing. Because it works through this different pathway rather than serotonin alone, relief can begin within days instead of the weeks typical antidepressants take. At Avesta, depression is treated as part of a full diagnostic picture: we screen you, recommend a treatment path, and bring your mental health team into the conversation. 

You may recognise yourself here

If several of these describe your last few months, a consult is worth twenty minutes of your time.

  • A low or empty mood that does not lift, most of the day, nearly every day
  • Loss of interest in things you used to enjoy
  • Fatigue or low energy, even after rest
  • Sleeping far more or far less than usual
  • Changes in appetite or weight, up or down
  • Trouble concentrating or making decisions
  • Feelings of worthlessness or excessive guilt
  • Recurring thoughts of death, or not wanting to be here

And you have already tried the following

  • Two or more antidepressants without adequate relief
  • Talk therapy that helps you cope but has not lifted the weight
  • Being told to try “just one more medication” or wait longer
  • Days where getting out of bed feels like the hardest part

That history matters — it is exactly what makes a different mechanism worth considering.

Why It Persists

Why depression can stall and how ketamine works differently

A different target than standard antidepressants

SSRIs and SNRIs work on serotonin and norepinephrine, and they take weeks to build. Ketamine acts on glutamate — the brain's main excitatory neurotransmitter — by blocking NMDA receptors and triggering a downstream cascade that most patients feel within days rather than months.

Restoring balance, not just serotonin

Depression is linked to low levels of both glutamate and GABA, the neurotransmitter that helps calm the brain. Ketamine raises glutamate and, in turn, GABA production — helping reset the chemistry behind depressive symptoms rather than masking them.

A window where therapy lands differently

For several days after dosing, the brain is measurably more plastic. We aim to take advantage of this window by pairing  treatment with integration coaching or ketamine-assisted psychotherapy. Our goal is to reinforce new habits instead of a temporary lift.

Where the evidence is strongest

Treatment-resistant depression is ketamine's best-studied use in psychiatry, and the only FDA-approved indication for esketamine (Spravato). We will still confirm it is the right fit for your history before recommending a series.

Our team monitors you throughout your session so that you can relax and feel safe. 

How Avesta Treats It

Our treatment options

We do not sell one package to everyone. After screening, your clinician recommends the path with the strongest evidence for your history — and says so plainly when ketamine is not the answer.

Most common starting point

IV Ketamine Therapy

Best studied route for depression, especially when it travels with anxiety or chronic pain

  • 45–60 minute sessions, six to eight over two to three weeks
  • Dose titrated to you & adjusted between sessions if necessary
  • Vitals monitoring throughout
  • Boosters scheduled when your response calls for it
Treatment details →
FDA-approved for TRD

Spravato (esketamine)

The only FDA-approved esketamine treatment, for treatment-resistant depression and for MDD with acute suicidal ideation

  • In-network with many plans
  • Delivered in our REMS-certified clinics
  • Two-hour monitored visit, twice weekly at first
  • Often paired with your existing antidepressant
Treatment details →

Ketamine-Assisted Psychotherapy

When avoidance, trauma or long-standing patterns are driving the depression

  • Licensed therapist in the room to provide trauma support
  • Structured preparation and integration sessions
  • Coordinated with your existing therapist
Treatment details →

Integration Coaching

Between and after sessions, to make the gains hold

  • Accompanied by a psychedelic- or ketamine-trained coach
  • Preparation for your first treatment
  • Sitting sessions during treatment for emotional support if wanted
  • Integration sessions after
Treatment details →

What To Expect

From first call to maintenance, step by step

  1. 01

    Free 30-minute consult

    A clinician reviews your diagnosis, medications and history, answers questions and tells you candidly whether ketamine is a reasonable next step. We require an official diagnosis but do not require a referral. This is a free step in the process.

  2. 02

    Medical & psychiatric screening

    Blood pressure, cardiac and psychiatric history, current prescriptions and substance history are reviewed before anything is scheduled. Some people are safely declined at this stage if they are not the right candidate.

  3. 03

    Your first session

    You arrive with a ride home arranged. Dosing takes 45–60 minutes in a private room with a clinician present, followed by a short recovery period. Most people describe it as floaty and dreamlike.

  4. 04

    The initial series

    Six to eight sessions over two to three weeks. Many patients notice a shift around the fifth or sixth session; your provider re-scores symptoms and adjusts dose along the way.

  5. 05

    Integration

    Coaching or KAP alongside the series if you do not have your own mental health provider. We also proactively reach out to your mental health team along the way to coordinate care.

  6. 06

    Maintenance

    Boosters scheduled by response. Our goal is to have you taper down to a minimal number of visits, not to stay on our patient list forever.

Free 30-Minute Consult

  • No cost, no referral needed
  • Benefits checked up front
  • A clinician on every call
Book my consult(301) 381-8381

Please do not include medical details in web forms. In a crisis, call 988.

Other Conditions We Treat

Dr. Ladan Eshkevari, PhD, CRNA, FAAN, founder of Avesta Ketamine and Wellness, with a patient
Who Sets Our Protocols

Dr. Ladan Eshkevari, PhD, CRNA, FAAN

Founder & Co-CEO · Georgetown University faculty

Dr. Eshkevari led a study with her Georgetown graduate students published in the Journal of Psychiatric Research, supporting ketamine therapy for people living with treatment-resistant depression. She sets the clinical protocols used at every Avesta clinic.

Read the published study (PDF)Watch her interview

Patient Reviews

What real patients say on Google

ExcellentBased on 225 reviews
Write a review
Amy GutierrezAugust 18, 2026BethesdaGoogle
I have had the pleasure of going to 3 locations- Bethesda, Tyson, and DC. Every experience has been phenomenal and the staff makes sure you are heard and happy. Both before the infusion and afterwards. They are all amazing and have the best bedside manners!
Wendy LaffermanSeptember 25, 2026ColumbiaGoogle
This was my first visit to Avesta for a Ketamine infusion for chronic migraine pain comorbid with mental health diagnosis.

Coming in with a lot of anxiety due to past experiences, I was greeted by Nyla who was kind, patient, and empathetic throughout my entire visit. She was there to answer any questions I had. The environment was quiet and peaceful; with a sign as a reminder.

My practitioner, Nate, was amazing. He was caring and intentional. Communicated every step of the process and eased all my fears; specifically getting the IV on the first stick!! Both checked in on me often throughout the infusion to ensure I was having the best possible experience.

I’m incredibly grateful that I found this place and am looking forward to my next visit!
Kate GowingAugust 2, 2026Norfolk/Virginia BeachGoogle
Great treatment, been coming to Avesta in DC for a while. Glad they finally opened closer to me.
Spencer AgostiniAugust 2, 2026TysonsGoogle
Avesta is the best ketamine clinic in Northern Virginia. I did my research and I'm so glad I decided to go with Avesta.
Matthew ConnorsSeptember 10, 2026Washington DCGoogle
Nice atmosphere, professional staff that are also warm and friendly. I won't go anywhere else.
Paul ThompsonJuly 3, 2026BethesdaGoogle
Meghan was well informed, polite, answered all of my questions clearly and in the context of our conversation she provided information she discerned to be important to me.
Toby KatesAugust 2, 2026ColumbiaGoogle
Excellent clinic for Spravato treatments, they are so friendly and welcoming.
Carole WilkinsFebruary 10, 2026TysonsGoogle
As always the experience was top notch. Nate and Gillian saw to it that my needs were met and questions answered. I always feel like I’m in the best hands when I’m there. These treatments are life savers for me.
Elsa AlaswadJuly 18, 2026Washington DCGoogle
This place is a haven for me. What makes it the most special are the people who work here, especially Abigail and Arielle. They make the whole experience feel safe and comfortable. Abigail is a wonderful and caring future physician who makes you feel right at home. She’s a joy to have around. Arielle is an expert at IV placement in addition to being an amazing healthcare provider with impeccable bedside manner. I love to see she’s the NP on because I know I’m gonna be in extremely capable hands. Avesta is my happy place. Thank you for making my life better.
D SMay 3, 2026BethesdaGoogle
Excellent service and facility.
Carolyn ErwinAugust 1, 2026ColumbiaGoogle
No complaints. Always feel better after my sessions!
B CJanuary 16, 2026TysonsGoogle
I love this place. It’s comfortable and the staff is so nice. Dion Gillian and Mimi are the best. I highly recommend them.

What The Care Looks Like

Setting your expectations

Weeks, not monthsTypical onset

If you are responsive to Ketamine, the effects can be felt around the 5th or 6th session. For responders, ketamine's effects can be measurable far faster than oral medications.

6-8 sessionsStandard initial series

Delivered over two to three weeks, then reassessed against your baseline scores.

Symptom scoringAt every visit

We send you mood surveys to track validated symptom scales so that you can recognize how far you've come, in addition to how your mood progresses.

Individual results vary. Spravato (esketamine) is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with MDD with acute suicidal ideation or behavior; IV ketamine for depression is used off-label. Nothing here is a promise of outcome or a substitute for evaluation by a clinician.

Candidacy

You may be a candidate if…

Screening happens before anything is booked. Being told no is a legitimate outcome of a consult.

Likely a good fit

  • You are 18 or older with a diagnosed depressive disorder, alone or with anxiety, PTSD or chronic pain
  • Two or more medications or a course of therapy has not given you enough relief
  • Your blood pressure and cardiac history are stable or well managed
  • You can arrange a ride home after each session
  • You are willing to keep working with a therapist or prescriber alongside treatment

We would pause or refer out if

  • Uncontrolled high blood pressure, or recent heart attack or stroke
  • Active, untreated psychosis or mania
  • Pregnancy or breastfeeding
  • Active, unmanaged substance use — we will help you sequence care first
  • A history that points to a different treatment; we refer out rather than sell you a series

Safety standards on every visit

  • Full medical and psychiatric history reviewed before your first visit
  • Vitals are checked and you are monitored during treatment
  • Emergency protocols and medications on site at every clinic
  • LegitScript-certified practice, REMS-certified for Spravato
  • Written coordination with your therapist or psychiatrist

Insurance & Cost

In plain terms, before you commit

We verify your benefits and give you an out-of-pocket estimate on your consult call.

Spravato

In-network with many commercial plans. We run your benefits and give you an out-of-pocket estimate before you commit to anything.

IV ketamine

Generally out-of-network. We provide superbills for reimbursement claims and HSA/FSA funds are usually eligible.

Veterans & military families

We work with Veterans Affairs Community Care to serve our military families directly.

First responders 

Ask during your consult call for discounted pricing for first responders, current military or veterans. 

Locations

Our Ketamine Clinics in Washington, DC, Maryland & Virginia

Every Avesta location is staffed by a licensed clinician for every session.

Washington, DC clinic
Washington, DC

1400 16th St NW, Suite 101

(202) 735-1183
Bethesda, Maryland clinic
Bethesda, Maryland

4833 Rugby Ave, #400

(301) 200-9333
Columbia, Maryland clinic
Columbia, Maryland

5840 Banneker Rd, Suite 270

(301) 381-8381
Tysons, Virginia clinic
Tysons, Virginia

8000 Towers Crescent Dr, Suite A150

(703) 646-6343
Norfolk / Virginia Beach, Virginia clinic
Norfolk / Virginia Beach, Virginia

6275 E. Virginia Beach Blvd, Suite 103

(301) 381-8381

FAQs

Common questions about depression

Is ketamine FDA-approved for depression?

It depends on the route. Spravato (esketamine) is FDA-approved specifically for treatment-resistant depression and for depressive symptoms in adults with MDD with acute suicidal ideation or behavior. IV ketamine itself is not FDA-approved for depression and is used off-label, though it is the most studied off-label use of ketamine in psychiatry. On your consult we explain exactly which route applies to your diagnosis and why.

How quickly might I feel a difference?

Ketamine acts far faster than oral antidepressants — some people notice a change within days. In a standard six-to-eight-session series, patients most often report a meaningful shift around the fifth or sixth session. Some do not respond, and we tell you rather than extending the series indefinitely.

Can I keep taking my current antidepressants?

Usually yes. Most patients continue their prescriptions throughout treatment, and Spravato is often used alongside an existing oral antidepressant. Your clinician will review your full medication list and coordinate any changes with your prescriber — never on your own.

What does a session actually feel like?

Most people describe a floaty, dreamlike state with altered sense of time and body, lasting about the length of the dose. It is not painful and you remain able to communicate with the clinician in the room. Nausea and mild dizziness are the most common side effects and are treatable on the spot.

How much does it cost?

It depends on the route. Spravato is in-network with many plans; IV ketamine is typically out-of-network with superbills provided. We verify your benefits and quote your out-of-pocket cost before you schedule — no surprise billing.

Do I need a referral?

No. You can book a free consult directly. If you have a therapist or psychiatrist, we will ask permission to coordinate with them, because outcomes are better when your care team is aligned.

Is it safe?

In a monitored clinical setting with proper screening, ketamine has a well-established safety profile. Risks include transient increases in blood pressure and heart rate, dissociation, nausea and, with long-term unsupervised use, bladder and dependence concerns. That is precisely why every dose here is screened, dosed and monitored by a clinician.

Which clinic should I go to?

We have five: Washington DC, Bethesda, Columbia, Tysons and Norfolk/Virginia Beach. Not every clinic offers every treatment, so we match you to the nearest location that offers the route you need.