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Condition · Anxiety

Ketamine therapy for anxiety in DC, Maryland & Virginia

Anxiety is defined by the American Psychological Association (APA) as "an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure." It affects approximately 40 million Americans, or 18.1% of the population, making it the most commonly diagnosed mental illness in the country.

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Patient resting in a sunlit Avesta treatment room during an anxiety infusion session
10+ yrsTreating patients in the DMV
4.9★Average Google rating
5Clinics across DC, MD & VA
1,000+Patients treated to date

Ketamine acts on the brain's glutamate system rather than serotonin, which is why it can help anxiety that has not responded to SSRIs, SNRIs or therapy alone. At Avesta, anxiety is treated as part of a full diagnostic picture: we screen you first and make a recommendation as to whether ketamine can help you based on what your history supports. 

You may recognise yourself here

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

  • Worry you cannot switch off, even when nothing is wrong
  • Racing heart, tight chest, shallow breathing or nausea in ordinary situations
  • Avoiding work meetings, driving, social plans or travel
  • Broken sleep, early waking, or lying awake rehearsing conversations
  • Irritability and a short fuse with the people closest to you
  • Panic attacks that arrive without warning
  • Difficulty concentrating; simple decisions feel enormous
  • Anxiety layered on top of depression, PTSD or chronic pain

And you have already tried the following

  • Talk therapy or CBT that helps you cope but does not lower the baseline
  • Benzodiazepines you would rather not stay on

Your history is what makes a different mechanism worth considering.

Why It Persists

Why anxiety can stall — and how ketamine works differently

A different target than standard anxiety medication

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.

Rebuilding connections that chronic stress wears down

Sustained anxiety and stress are associated with loss of synaptic connections in the prefrontal cortex, the region that regulates fear and worry. Ketamine promotes synaptogenesis, which is the leading explanation for why symptom relief can outlast the drug itself.

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 it is honestly less clear

The strongest evidence for ketamine is in treatment-resistant depression; anxiety data is smaller and often studied alongside depression since they are co-occurring. However, there IS good evidence that ketamine can help patients struggling with Social Anxiety disorder (SAD), refractory and Generalized Anxiety disorder (GAD). 

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 anxiety that travels with depression or chronic pain

  • 45–60 minute sessions, six over two to three weeks
  • Dose titrated to you, adjusted between sessions
  • Clinician and vitals monitoring throughout
  • Boosters scheduled only when your response calls for it
Treatment details →
Insurance pathway

Spravato (esketamine)

When treatment-resistant depression sits underneath the anxiety and you need insurance coverage

  • FDA-approved only for TRD, so only applicable for you if you are struggling with co-occurring depression
  • In-network with many plans
  • Delivered in our REMS-certified clinics
  • Two-hour monitored visit, twice weekly at first
Treatment details →

Ketamine-Assisted Psychotherapy

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

  • 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 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. Ketamine is not FDA-approved for anxiety and is used off-label for this indication; Spravato (esketamine) is FDA-approved only for treatment-resistant depression and for depressive symptoms in adults with MDD with acute suicidal ideation or behavior. 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 anxiety disorder, alone or with depression, PTSD or chronic pain
  • At least one medication or 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
  • A clinician is present and vitals are monitored for every dose
  • Emergency protocols and medications on site at every clinic
  • LegitScript-certified practice, REMS-certified for Spravato
  • Written coordination with your therapist, psychiatrist and primary care team

Insurance & Cost

In plain terms, before you commit

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

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 anxiety

Is ketamine FDA-approved for anxiety?

No. Ketamine is FDA-approved as an anesthetic and is used off-label for mood and anxiety conditions, which is legal and common in psychiatry. Spravato (esketamine) is FDA-approved specifically for treatment-resistant depression and for MDD with acute suicidal ideation or behavior. 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-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 anxiety medication?

Usually yes. Most patients continue their prescriptions throughout treatment. Certain medications, particularly benzodiazepines and lamotrigine, can blunt the response, so your clinician will review your 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.