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Condition · Migraines

Ketamine infusion therapy for migraines in DC, Maryland & Virginia

Migraines affect roughly 12% of the U.S. population, and women are three times more likely to experience them than men — yet for many, no clear cause or lasting solution ever turns up. Ketamine is increasingly used for chronic and refractory migraines that have not responded to conventional therapies.

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A patient resting comfortably during a monitored 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 treats migraines on several fronts: it blocks NMDA receptors to reduce central sensitization, lowers glutamate activity to decrease the neuronal hyperexcitability characteristic of migraines, disrupts pain pathways directly, and has anti-inflammatory properties that can ease brain inflammation during an attack. At Avesta, we follow a pain protocol of 3 to 5 four-hour sessions on subsequent days, followed by intermittent booster infusions based on your response.

You may recognise yourself here

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

  • Migraines that strike multiple times a month, sometimes weekly
  • Head pain severe enough to stop you mid-day, every time
  • Nausea, light sensitivity or visual aura accompanying your migraines
  • Migraines that have not responded to triptans or standard preventive medication
  • Missing work, family time or plans because of migraine days
  • Cycling through medications without finding lasting relief
  • A migraine pattern with no clear identifiable trigger
  • Fear of the next attack shaping how you plan your days

And you have already tried things

  • Triptans or standard abortive medications with limited or fading relief
  • Preventive medications without enough reduction in frequency
  • Being told migraines are “just something you live with”
  • Botox or nerve blocks with partial or temporary relief

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

Why It Persists

Why migraines can stall — and how ketamine works differently

Quieting an oversensitive nervous system

Ketamine blocks NMDA receptors to reduce central sensitization — the heightened nerve sensitivity that keeps migraine pain cycling.

Lowering the excitability behind migraines

Ketamine reduces glutamate activity, decreasing the neuronal hyperexcitability that is a hallmark of migraine attacks.

Interrupting pain pathways directly

Ketamine disrupts the pain pathways involved in migraine, which can provide relief where other approaches have not.

Calming inflammation during an attack

Ketamine's anti-inflammatory properties help reduce inflammation in the brain, which can bring relief during migraine attacks.

A clinician stays with you and monitors vitals for the entire session — never a room left unattended.

How Avesta Treats It

Our treatment options

We do not sell one package to everyone. After screening, your clinician builds a plan around your specific migraine pattern and history.

Pain protocol

IV Ketamine Infusions

Our primary treatment for migraines, following a structured pain protocol

  • 3 to 5 sessions on subsequent days
  • Each session is about four hours long
  • Followed by intermittent booster infusions
  • Customized to your migraine pattern and history
Treatment details →

IV Vitamin Infusions

Nutrient-rich infusions that support your body's broader recovery alongside pain treatment

  • Complements your ketamine protocol
  • Tailored to your individual needs
  • Delivered same-day at most clinics
Treatment details →

Integration Coaching

Between sessions and beyond

  • 1:1 sessions between infusions
  • Trigger tracking and routine work
  • Booster scheduling based on your response
Treatment details →

What To Expect

From first call to maintenance, step by step

  1. 01

    Free 30-minute consult

    A clinician reviews your migraine history, prior treatments and current medications, and tells you candidly whether ketamine is a reasonable next step. No referral needed, no cost, no obligation.

  2. 02

    Medical screening

    Blood pressure, cardiac history and current prescriptions are reviewed before anything is scheduled.

  3. 03

    Your first infusion

    Sessions run about four hours in a private room with a clinician present. Arrive with a ride home arranged.

  4. 04

    The full protocol

    3 to 5 sessions delivered on subsequent days, customized to your migraine pattern.

  5. 05

    Reassessment

    Your provider evaluates your response and determines your booster schedule from here.

  6. 06

    Maintenance

    Intermittent booster infusions keep your pain pathways at bay, scheduled by response, not by package.

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 migraines and is used off-label for this indication, following a structured pain protocol. 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 have chronic or refractory migraines that have not responded to conventional therapies
  • Standard medications (triptans, preventives) have 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 (sessions run about four hours)
  • You can commit to 3 to 5 consecutive treatment days for the initial protocol

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.

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 migraines

Is ketamine FDA-approved for migraines?

No. Ketamine is FDA-approved as an anesthetic; its use for migraines is off-label, though it is increasingly used for chronic and refractory migraines that have not responded to conventional therapies. On your consult we explain what the evidence supports for your specific pattern.

What is the treatment protocol?

We follow a pain protocol of 3 to 5 sessions on subsequent days, each about four hours long, followed by intermittent booster infusions based on your response.

Who is a good candidate for ketamine migraine treatment?

Ketamine is generally considered for chronic or refractory migraines — ones that have not responded well to triptans, preventive medications or other conventional therapies. Your consult will help determine whether that describes your history.

What does a session actually feel like?

Most people describe a floaty, dreamlike state with altered sense of time and body. 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?

IV ketamine for migraines is typically out-of-network, and we provide superbills for reimbursement claims. 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 neurologist or headache specialist, 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 and nausea. 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.