Nasal Ketamine Therapy at Thrive IV

A faster path toward feeling like yourself again.

A medically supervised option for treatment-resistant depression, anxiety, and PTSD — prescribed, dosed, and guided by our licensed clinicians.

Compounded ketamine • Provider-supervised • Personalized to you

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What it is

A gentler, more flexible way to use a well-studied medicine.

Ketamine has been used safely in medicine for decades. At lower, carefully measured doses, it works on the brain in a way that is fundamentally different from traditional antidepressants — and for many people, it brings relief in days rather than months.

Our nasal ketamine is a compounded medication, delivered as a simple nasal spray. Because it is compounded, our clinicians can tailor your dose and your plan to you, rather than fitting you into a one-size protocol. Insurance companies limit the dosing so when we have this compounded, Dr Pellegrino can offer whatever dose is best without limitations or constraints.

Every step happens under medical guidance, from your first evaluation through each session and the follow-up care that helps the benefits last.

What it may help

When the usual options haven’t been enough.

Many people come to us after trying other treatments without the relief they hoped for. Under a provider’s care, nasal ketamine may help with:

• Treatment-resistant depression — For depression that hasn’t responded to one or more antidepressants, ketamine offers a different mechanism, and often a quicker shift in mood.
• Anxiety — Persistent, hard-to-quiet anxiety can ease as ketamine helps the brain step out of entrenched patterns of worry.
• PTSD & trauma — Evidence here is still emerging, but for some people ketamine may soften rigid thought loops, creating space to process trauma alongside therapy and ongoing support.

Some people also explore ketamine for certain chronic pain conditions. Whether it is right for you is determined by a licensed physician after a full evaluation.

How it works

It helps the brain make new connections.

Traditional antidepressants mostly work on serotonin and related brain chemicals, and can take four to eight weeks to help. Ketamine takes a different route: it acts on glutamate, the brain’s most abundant excitatory neurotransmitter.

In doing so, it is believed to encourage neuroplasticity — the brain’s ability to form fresh connections and break out of the stuck patterns that depression and anxiety reinforce. Delivered nasally, it is needle-free, comfortable, and works quickly.

The process

What to expect, step by step.

Calm, unhurried, and supervised from start to finish.

1. Consultation — A licensed provider reviews your history, current treatments, and goals to see whether ketamine is a safe fit for you.
2. Your plan — We compound a dose tailored to you and walk you through exactly what each session will feel like.
3. Guided sessions — You receive your nasal spray in a quiet, comfortable setting and are monitored throughout by our clinical team.
4. Follow-up & care — We check in, adjust as needed, and coordinate with your therapist or physician so progress holds.

At a glance

• Format: Compounded nasal spray
• Setting: Provider-supervised, calm environment
• Onset: Many notice shifts within hours to days
• Dosing: Personalized by your clinician
• Oversight: Evaluation, monitoring & follow-up included

Our approach: compounded ketamine, not Spravato

You may have heard of Spravato, the FDA-approved esketamine spray. We can take a different approach, based on your needs and insurance coverage. The two are closely related, but not the same — and we want you to know exactly what you are getting.

• What we offer: Compounded racemic ketamine — containing both mirror-image forms of the molecule — which our clinicians can tailor in dose and plan to fit you.
• How it differs from Spravato: Spravato uses only one form of the molecule (esketamine) in fixed doses within a rigid program. Although for many Spravato may be the right choice, there are some patients where racemic ketamine intranasal is a better option. Our compounded approach allows for a more personal, flexible experience.
• Good to know: Compounded ketamine is prescribed off-label and is not FDA-approved for these conditions. It is typically paid out of pocket rather than billed to insurance. Sometimes, we can bill your insurance for the in office monitoring. The patient would be responsible for the cost of the medication for each session which is not covered by insurance plans. (This is in addition to billing your insurance for the office treatment monitoring).

We are happy to talk through the difference during your consultation.

Safety & candidacy

Care that’s built around your safety.

Ketamine therapy isn’t right for everyone, and that is exactly why every plan starts with a thorough evaluation.

• Thorough screening — We review your medical and mental health history, medications, and blood pressure before recommending treatment.
• Always supervised — Sessions take place under clinical monitoring; you are never managing the experience alone.
• Measured, low doses — Therapeutic doses are far lower than recreational use, and managed carefully by your provider.
• Honest about fit — Certain conditions may make ketamine unsafe. If it isn’t right for you, we’ll tell you and help you find alternatives.

Side effects are usually mild and short-lived — most often a temporary rise in blood pressure or heart rate, nausea, or a dissociative feeling during the session. With frequent or long-term use there are additional risks, including bladder and urinary problems; your provider will review these with you before you begin.