Best Ketamine Therapy

Out of the 8.9 million adults in America with medication-treated major depressive disorder (MDD), 2.8 million of them — about 31% — have treatment-resistant depression (TRD).1 This is a form of MDD diagnosed when at least two different antidepressants haven’t been able to sufficiently help a patient despite adequate treatment durations and dosage adjustments.2

Thankfully, “treatment-resistant” doesn’t mean that effective treatments aren’t available. One potential option that’s grown rapidly in popularity over the past few years is ketamine therapy.3 The off-label use of this anesthetic drug hasn’t just shown promise for those suffering from treatment-resistant depression; it’s also demonstrated positive results as a therapy for a multitude of other mental and physical health concerns, including PTSD, anxiety, substance use disorders, and chronic pain, to name a few.4

In this guide, we cover everything you need to know about ketamine therapy and compare the top online providers in terms of their cost, treatments, safety, convenience, availability, and more. If you’re short on time, check out our summary of recommendations below.

Over the past two decades, Innerbody Research has helped tens of millions of readers make more informed decisions involving staying healthy and living healthier lifestyles.

For our guide to the best online ketamine therapy providers, we spent over 100 cumulative hours researching ketamine therapy and learning about the available treatment providers. Our deep dive into the science behind ketamine therapy included investigating its history, benefits, safety, side effects, legal status, and more. Our team also gained hands-on experience with each of the platforms in this guide to accurately detail the patient experience.

Additionally, like all health-related content on this website, this review was thoroughly vetted by one or more members of our Medical Review Board for accuracy. As research on ketamine therapy evolves, we’ll update this guide accordingly.

When evaluating online ketamine therapy providers across the competitive landscape, we considered five key patient-centric criteria: the company’s safety measures, the available treatment plans, the value for your money, how widely available the service is, and the convenience of the overall therapy experience.

Let’s see how each of our top picks fared.

Safety

Winner: Innerwell

Since ketamine is “a dissociative anesthetic that has some hallucinogenic effects,” the best ketamine therapy services need to prioritize every patient’s safety (and comfort) during treatment.5 Innerwell, Mindbloom, and Better U each supply patients with the basics for safe ketamine treatment, such as by sending them blood pressure monitors and providing an initial health consultation with a doctor.

However, there are a few things that set Innerwell apart from Mindbloom and Better U as our winner for safety. The chart below breaks down the details.

Out of our top picks, only Innerwell’s integration is led by licensed mental health professionals — psychiatric clinicians, to be precise. Moreover, each patient will meet with their assigned clinician multiple times over the course of their treatment, not just once. This close, repeated contact with a licensed mental health care professional means that safety concerns may be able to be more easily reported or even caught by the clinician if unnoticed by the patient.

The second row in the above chart is about age-verification policies. Since ketamine is a controlled substance, it’s important to know that these platforms ensure that the person being prescribed the treatment is who they say they are and that they’re an adult. Innerwell, Mindbloom, and Joyous all outright say that your ID will need to be verified. Better U, on the other hand, only states that employees “may ask” for verification. Some telehealth platforms have gotten in trouble for verifying IDs but not ages before approving treatments.6

The final row is about sitter requirements. A sitter is a trusted person over the age of 18 who basically “babysits” you during your ketamine sessions. Innerwell, Mindbloom, and Better U all require this, which is appreciated, as patients will at least have someone nearby to spot any major changes in their health status. (Joyous doesn’t require sitters due to its very-low-dose treatment approach.)

So, by having integration sessions with clinicians, verifying ID, and requiring a sitter, Innerwell stands out for safety among our top picks.

(As a side note, the above information doesn’t mean Joyous isn’t safe — we wouldn’t recommend it if it wasn’t — the treatment program is just managed differently, and patients are more independent. When it comes to extra safety tools, the service likely doesn’t include a blood pressure monitor because its doses are so low. However, there are daily check-ins via text messaging with Joyous, and patients can speak with medical professionals if necessary to adjust their doses or discuss symptoms.)

Treatment plans

Winner: Innerwell

Innerwell, Mindbloom, and Better U each provide a variety of treatment options (Joyous only offers one). However, Innerwell came out on top in this criterion primarily due to the availability of both a standard eight-dose plan and an extended 24-dose treatment plan, the longest ketamine therapy plan we’ve encountered. (To clarify, though Joyous does provide patients with 30 daily ketamine lozenges at a time, they’re very-low-dose ones, which may not be suitable for everyone. So, in this case, we mean that Innerwell offers the longest treatment plan that uses standard ketamine therapy dosing.)

Innerwell also offers its patients the option to add services like psychiatry, talk therapy, or eye movement desensitization and reprocessing (EMDR) to their treatment plan. Better U provides talk therapy and psychiatry services on its platform, too, but they don’t appear to be add-ons; you can sign up for those services alongside ketamine therapy, but they’re not offered from the outset during your ketamine therapy intake like with Innerwell (and some of Innerwell’s add-ons can be integrated into your ketamine treatment, unlike with Better U).

Cost

Winner: Better U

Even though Better U isn't the least expensive on our list, we feel that it offers patients the best value for their financial investment. To better understand what we mean, first check out this chart for a quick reference comparing the total cost and price-per-dose of each of our top picks:

If you examine only the treatment costs, Joyous would be the winner by far. But the reason that Joyous is so much more affordable is that it doesn't provide as much as the competition:

• Treatments use very-low-dose ketamine (lower doses than those used by competitors)
• Sessions are independent; they’re not guided by a coach or clinician
• Peer support isn’t offered
• There are no supportive therapy options (talk therapy, EMDR, guided programs, etc.)
• You aren’t given any extras like a starter kit, blood pressure cuff, or journal
• Communication is done primarily over text or by filling out online check-in forms

These aren’t inherently negative things, but they could be seen as such by those looking for the more “traditional” style of ketamine therapy advertised by most providers. But if you’re a ketamine therapy veteran and know that you don’t need all the extra support offered by the other services, then Joyous (and its low monthly price) could be a perfect fit for you.

Better U, on the other hand, uses typical ketamine therapy dosing and does give patients access to those aforementioned extras — all at a lower price than its closest competitors. It’s also the only service out of our top picks that offers customers a pay-as-you-go financing option, which can reduce costs to as low as $54 per month. All Better U patients can apply for financing, but approval is only guaranteed for patients who sign up for the nine-session “Transformation” package. The five-dose “Introduction” plan can still be financed, of course, but there is the possibility that your application won’t be approved.

If you aren’t eligible for financing, Better U also offers patients the option to pay at checkout using the installment services Affirm or Afterpay.

Availability

Winner: Mindbloom

It’s not uncommon for telehealth providers to not be available in all 50 states, and online ketamine therapy platforms are no exception. Here’s a quick breakdown (accurate at the time of this writing) of how many territories our top picks are available in:

• Mindbloom: 35 territories
• Better U: 31 territories
• Joyous: 30 territories
• Innerwell: 25 territories

With 35 eligible states, Mindbloom has the best overall availability, but both Better U and Joyous aren’t too far behind. Innerwell is a bit more disappointing, serving fewer than half of the territories in the country. As our top choice for most people (when it’s available), we hope Innerwell will soon expand its availability.

Convenience

Winner: Joyous

Since all of our top picks offer at-home ketamine therapy through telehealth, they all have a certain degree of inherent convenience that doesn’t exist with in-clinic appointments. However, only Joyous allows patients to go through their sessions without a “sitter” or treatment monitor — a trusted adult who needs to be physically present with you throughout the duration of all your sessions.

To clarify, we are not against the idea of a sitter requirement — quite the opposite, in fact. Generally, making sitters a treatment necessity is a great thing for patient safety and comfort, especially since ketamine is a drug that can come with mind-altering side effects (e.g., some experts have compared the drug’s effect on patients’ sense of “body ownership” to that seen in schizophrenia).7

Nonetheless, not everyone who could benefit from at-home ketamine therapy has access to a person who fits the sitter role. For instance, those with depressive disorders often have small social groups or inadequate social support.8 If someone has treatment-resistant depression that could be relieved by ketamine therapy, there is the possibility that they may not have someone in their life who could act as a sitter. With Joyous, the ketamine doses are very low, meaning that there shouldn’t be any psychedelic effects. Because of this, sitters aren’t required by the company, and the unavailability of one won’t act as a barrier to treatment.

In this section, we’ve put together a couple of charts comparing and contrasting some of the most important details of our top picks, such as their pricing, treatment lengths, insurance acceptance, availability, and more.

This next chart shows which online ketamine therapy services are available in which U.S. territories:

As you can see, those who live in certain territories (like Washington, California, Texas, Pennsylvania, New Jersey, and a few others) can have their pick of any service mentioned in this guide, while others have more limited options — if any at all.

Ketamine hydrochloride (most often referred to as just “ketamine”) is a Schedule III controlled substance that is currently only FDA-approved for the “induction and maintenance of general anesthesia.”9 When providers — either online or from in-person clinics — prescribe ketamine for any other purpose, it’s considered “off-label use” and isn’t FDA-approved.10

Though most of the existing research on ketamine therapy has been focused on its potential to relieve symptoms of depression, several studies have also investigated it as a possible treatment for concerns like anxiety, PTSD, OCD, chronic pain, and more.11 12

It’s important to clarify that when ketamine is prescribed off-label for the aforementioned concerns (or others), it’s administered at doses far lower than those used for anesthesia. For example, according to experts, the average dose of intravenous ketamine needed to induce 5-10 minutes of anesthesia is 2mg/kg, meaning a 190lb adult would be given a dose of roughly 172mg.13 Depending on how long the procedure is — and if other anesthetics are being used — that amount could be multiplied several times over. In comparison, a 2017 review noted that therapeutic ketamine for depression “is most commonly administered in the dose of 0.5 mg/kg,” or a fourth of the average anesthetic dose, over a session of around 40 minutes.14

Typically, telehealth ketamine therapy services use oral/sublingual administration via tablets or troches (lozenges) that you let dissolve in your mouth — usually under your tongue or against your cheek — then wait the instructed amount of time before spitting out the remainder of the tablet/troche, along with your saliva. (Swallowing your ketamine-infused saliva or the tablet/troche is dangerous and can lead to overdose.)15

Some ketamine therapy services also offer other administration methods in addition to the usual dissolvable tablets or lozenges. Among the platforms discussed in this guide, Mindbloom recently began offering at-home subcutaneous injections, and Better U can provide in-person infusions or injections at its clinics in California, New York, and Florida.

Much of the potential of ketamine therapy is attributed to the drug’s apparent ability to promote increased neuroplasticity, also known as “neural plasticity” and “brain plasticity.” No matter what you call it, this process involves “adaptive structural and functional changes to the brain.”30 31

Basically, neuroplasticity is your nervous system’s ability to adapt and change its structure, functions, and connections in response to different stimuli, both internal (e.g., hunger, body temperature, emotions) and external (e.g., sounds, lights, smells, injuries). The concept of neuroplasticity is most commonly used when discussing how patients heal after a stroke or traumatic brain injury (TBI).31

As explained by experts, there are two major mechanisms at play with neuroplasticity:31

• Neuronal regeneration/collateral sprouting: This is when neurons generate or “sprout” additional branches to create new connections between existing neurons.32
• Functional reorganization: After a brain injury, the brain undergoes changes that, to put it simply, let other parts of the brain take over control of the injured part’s functions. How this happens isn’t yet fully understood, but two theories include equipotentiality (the opposing side of the brain sustains lost function) and vicariation (the brain can reorganize portions of itself to take on other functions).33

But how does promoting neuroplasticity help ketamine work as a possible treatment for certain mental and physical health concerns? We break it down below.

Ketamine therapy may be suitable for generally healthy individuals — not pregnant or breastfeeding — who are suffering from a condition or concern that the drug has shown potential in treating or relieving the symptoms of. These include:11

• Depression (particularly treatment-resistant depression)
• Anxiety, including social anxiety disorder
• Substance use disorders
• Eating disorders
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Late-stage illness
• Chronic pain12

If your health issue isn’t included in the above list but you’re still curious whether ketamine therapy may benefit you, we recommend speaking with your doctor or a provider from your service of choice to determine if it’s right for your unique situation. Three of our recommended options — Innerwell, Better U, and Joyous — offer free virtual consultations. (Mindbloom requires a hefty down payment before you can have a consultation.)

Who should look elsewhere?

Other than state availability issues, most of the reasons ketamine therapy may not be suitable for someone are health-related. The following groups could be better off looking elsewhere:

• Those who are pregnant or breastfeeding (ketamine could harm your baby)16
• Individuals with blood pressure concerns or heart disease17 18 19
• People suffering from serious mental health disorders (e.g., BPD, schizophrenia, schizoaffective disorder)20 21
• Those with liver or kidney disease22 23
• Anyone with a family or personal history of seizures or epilepsy24
• People on certain medications (anxiolytics, muscle relaxants, antiepileptic drugs, anticonvulsants, narcotics, bronchodilators, some antidepressants, etc.)19
• Those who have attempted suicide or are suffering from suicidal thoughts (this is often part of a ketamine therapy service’s exclusion criteria)

Also, for those who haven’t tried other, more conventional therapeutic approaches, it could be worthwhile to do so before trying ketamine therapy.25 If you don’t experience symptom relief after exhausting those options, then ketamine therapy may be something to consider.

Additionally, we’d be remiss not to acknowledge the fact that ketamine therapy — if it’s available in your state — can be pretty expensive. Even Joyous at $129 per month can pose a major financial burden to some. If you have insurance, it could be worth trying some covered alternatives first (the FDA-approved esketamine nasal spray, Spravato, may even be an option if you go this route). But if you don’t have insurance, some telehealth platforms can offer other affordable solutions. Hims, Hers, and Nurx, for example, all offer a selection of prescription medications for a variety of mental health conditions.

Ketamine, like many other controlled substances, isn’t without its risks.26 But despite ketamine’s fair share of negative press in recent years, when used as directed, the sub-anesthetic (lower) doses used in ketamine therapy should be relatively safe for patients who don’t have any contraindicating health statuses or medical conditions, such as:

• Being pregnant or actively breastfeeding16
• Having heart disease or blood pressure concerns (either high or low)17 18 19
• Dealing with certain serious mental health conditions, like BPD or psychotic disorders20 21
• Having liver or kidney disease22 23
• Taking certain medications like antidepressants, anti-anxiety drugs, narcotics, and others19
• Having seizures or epilepsy (including personal or family history)24

Now, as mentioned earlier in this guide, the United States Drug Enforcement Administration (DEA) classifies ketamine as a Schedule III drug.5 Schedule III substances are defined as those “with a moderate to low potential for physical and psychological dependence.”27 In comparison, and for reference, the following list details some other — but not all — substances that fall under each scheduling category:

• Schedule I (highest risk of abuse): LSD, heroin, MDMA, psilocybin, methaqualone
• Schedule II: Vicodin, cocaine, methamphetamine, oxycodone, fentanyl, Adderall, Ritalin
• Schedule III: Testosterone, anabolic steroids, Tylenol with codeine
• Schedule IV: Xanax, Ambien, Ultram, Valium, Provigil
• Schedule V (lowest risk of abuse): Lyrica, Parepectolin, Robitussin AC, Motofen

So, while ketamine doesn’t have as high of an addiction risk as, say, fentanyl or heroin, it does still have “moderate” potential for dependence, particularly in higher doses.28 This is one of many reasons why it’s important to adhere to the proper dosing and treatment frequency prescribed by your doctor. If, at any point during ketamine therapy, you feel like you may be becoming dependent on the drug, let your doctor know promptly.

Ketamine side effects

Being a sedating, dissociative drug, ketamine can come with some side effects. Some of its short-term (usually transient) adverse effects include:29

• Dreamlike states
• Hallucinations
• Sedation
• Difficulty learning, paying attention, and remembering
• Confusion
• Problems speaking
• Memory loss
• Muscle stiffness or numbness
• Issues moving (sometimes to the point of being immobile)
• Increased blood pressure
• Nausea or digestive upset
• Unconsciousness
• Slowed breathing (that, in severe cases, can lead to death)

Also, although ketamine therapy is typically used on a short-term basis, it’s worth mentioning the potential adverse outcomes from long-term use, such as:29

• Bladder pain or ulcers
• Kidney problems
• Stomach pain
• Poor memory
• Flashbacks
• Depression

It’s important to clarify that much of this information is based on the higher ketamine doses used by those who misuse the drug. Nonetheless, if you experience any unpleasant or persistent side effects during ketamine treatment, make sure to share your concerns with your prescribing physician; they’ll be able to determine what’s normal versus what’s worrisome.

Best for most people, best patient support, and best extended treatment option

Innerwell provides a range of online mental health services, including psychiatry, talk therapy, EMDR, psychedelic integration, and — of course — ketamine therapy.

Though each of our top picks has its own merits, there are a few standout aspects of Innerwell’s ketamine treatment that cemented it not only as our top pick for most people but also as the service with the best extended treatment plan and the best patient support. The most notable highlights are as follows:

• Innerwell is the only service in this guide with integration sessions run by a psychiatric clinician instead of a coach. This means that you’ll be able to discuss your treatment experiences — both the good and the bad — with a licensed doctor who specializes in mental health.
• Patients can choose from an eight-dose treatment program or a 24-dose one, the latter of which is the longest plan of any of our top picks (Mindbloom comes in second with an 18-dose option).
• Both Innerwell plans include one psychotherapy session in addition to the regular psychiatric clinician consultations. While competitors may offer apps with guided programs, an actual therapy session with a mental health professional can offer patients a truly personalized treatment experience. (Additional therapy sessions, EMDR, or psychiatry services can also be added on.)
• While the selection is a bit limited, Innerwell does accept certain insurance plans. None of our other picks accept insurance.

However, the biggest drawback of Innerwell is its limited availability. Currently, it’s only available in 25 states — that’s ten fewer than Mindbloom. However, credit where it’s due, we have noticed that the company is actively working to expand its coverage. During the writing of this guide, for instance, Montana was added to the list of eligible states. With that in mind, we hope Innerwell’s ketamine therapy will soon be accessible to a wider audience.

On the topic of accessibility, Innerwell (similar to Better U) also has offices in New York and California. The New York office offers in-person consultations, follow-up visits, and therapist-led ketamine treatment sessions, while the two California locations can provide in-person consultations or follow-up visits, but no ketamine treatment sessions.

Innerwell ketamine therapy pricing and accepted insurance plans

Innerwell offers two different ketamine therapy treatment regimens: The Foundation Program (eight-dose) and The Extended Program (24-dose). During sign-up, patients can add on extra services such as talk therapy, psychiatry, or EMDR for an additional cost.

You can pay for your Innerwell plan in full or in monthly installments, either entirely out of pocket or with some assistance from an accepted insurance plan. Unlike Better U, our choice for people on a budget, financing options are not currently available from Innerwell.

Here’s how the two Innerwell ketamine therapy plans compare:

Innerwell is the only one of our top picks that accepts a selection of insurance plans in most of its served states, and, as you can see, patients with an eligible plan stand to save a fair bit of money. The following list details the eligible plans at the time of this writing:

• Arizona: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• California: Aetna, Anthem Blue Cross of California, Blue Shield of California, Carelon Behavioral Health (formerly Beacon Health Options), Cigna/Evernorth Behavioral Health, Magellan Health, Sharp Health Plan, TriWest Healthcare Alliance of California, UnitedHealthcare/Optum, Zelis
• Colorado: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• Connecticut: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• Florida: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• Georgia: Zelis
• Illinois: Aetna, Blue Cross Blue Shield of Illinois, Cigna/Evernorth Behavioral Health, Zelis
• Iowa: Cigna/Evernorth Behavioral Health, Zelis
• Massachusetts: Cigna/Evernorth Behavioral Health
• Michigan: Cigna/Evernorth Behavioral Health
• Minnesota: Zelis
• New Hampshire: Aetna, Cigna/Evernorth Behavioral Health
• New Jersey: Cigna/Evernorth Behavioral Health, Zelis
• New York: Aetna, Cigna/Evernorth Behavioral Health, UnitedHealthcare/Optum, Zelis
• Ohio: Cigna/Evernorth Behavioral Health, Zelis
• Oregon: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• Pennsylvania: Aetna, Cigna/Evernorth Behavioral Health, Zelis
• Tennessee: Aetna, Cigna/Evernorth Behavioral Health
• Texas: Aetna, Blue Cross Blue Shield of Texas, Cigna/Evernorth Behavioral Health, Evry Health, UnitedHealthcare/Optum, Zelis
• Utah: Aetna, Zelis
• Virginia: Cigna/Evernorth Behavioral Health, Zelis
• Washington: Aetna, Cigna/Evernorth Behavioral Health, Regence BlueShield, UnitedHealthcare/Optum
• Wisconsin: Zelis

Idaho and Montana are the only two states served by Innerwell that currently have no accepted insurance plans. However, even if your insurance plan isn’t mentioned in the eligible plans list, the company can give you a superbill (itemized receipt) to submit for potential reimbursement through your insurance plan or HSA/FSA plan.

Best budget option

Available in 31 states, Better U is an online wellness platform that offers psychiatry, talk therapy, longevity treatments, sexual health support, weight loss medications, and more. However, the company is perhaps best known for its ketamine therapy program.

Better U’s ketamine therapy plans are relatively short compared to those offered by competitors. The company has two paths for patients to choose from: a five-dose plan and a nine-dose one. These options are each one dose higher than they were when we first investigated the company a few months ago. During the writing of this guide, the plans were extended without any change to their costs.

While it’s nice to see Better U add an extra session to each of its ketamine therapy plans, we do wish the company offered a truly extended treatment plan, like the 24-dose option from Innerwell or the 18-dose one from Mindbloom. Even though you can apply for treatment continuation with Better U, we’d still like to see a longer plan available from the outset.

Nonetheless, Better U still offers a generally more affordable ketamine therapy experience without compromising on patient support. Just like Innerwell and Mindbloom, Better U gives all patients a free starter kit that includes a blood pressure cuff, eye mask, and journal. However, Better U also includes a pair of heart diffraction glasses (they make lights look like hearts), most likely as a way to try to make treatment sessions more “fun” and positive.

Similar to Mindbloom, Better U has a companion app that offers patients structured sessions to use during treatments (categories include Heal, Grow, Love, Transcend, Healing from Sexual Trauma, PTSD, Processing Grief, and more), meditations, breathwork exercises, and trackers for your progress, moods, and symptoms. You can also message your Better U care team and attend one-on-one virtual sessions (e.g., integration coaching) in the app.

Additionally, if you live in New York, California, or Florida, you can go in person to a Better U clinic for your ketamine therapy sessions. In addition to the lozenges, the clinics also offer ketamine infusions and injections. It’s worth noting, however, that in-office treatments may be more expensive than at-home ones.

Better U ketamine therapy pricing

Better U offers two different packages for at-home ketamine therapy: Introduction (five sessions) and Transformation (nine sessions). The company explains that Introduction is intended for those with more recent mental health challenges (within the last year), while Transformation is for those whose concerns have been affecting them for longer (a year or more).

Here’s how the options compare:

After your treatment is over, you can continue with Better U at the reduced price of $79 per session. In comparison, Mindbloom’s returning client costs range from $128 to $159 per session (that’s up to an $80 difference between Better U and Mindbloom).

As with most of our top picks, Better U is not covered by insurance but does accept HSA/FSA (make sure to check with your plan administrator first). Additionally, if you aren’t approved for financing, Better U offers installment payments at checkout through Affirm or Afterpay. This variety of flexible payment options can improve treatment accessibility, and it’s one of the driving factors behind why we chose Better U as the best ketamine therapy for those on a budget.

Best injectable ketamine therapy and most widely available

Mindbloom is one of the more well-known telehealth ketamine therapy providers, and that could be due to its wide availability; at the time of this writing, its ketamine therapy is available in 35 states (ten more states than our top pick, Innerwell). Mindbloom is also the only service in this guide that offers at-home ketamine injections in addition to ketamine tablets.

While the subcutaneous injection option is appreciated — especially since quite a few ketamine therapy studies focus on intravenous or injection-based delivery — this could pave the way for a greater safety risk due to human error. These aren’t pre-filled syringes or auto-injector pens; it’s a manual process that’s up to the patient. If an erroneously high dose is taken due to improper syringe filling, it could lead to adverse effects or possibly even a higher risk of dependence (if it happens enough). If you want to play it extra safe when trying ketamine therapy, it may be best to stick with oral delivery.

Pivoting to the service itself, Mindbloom offers a pretty supportive platform overall. Your sessions can be customized through the Mindbloom app to fit your area of concern (e.g., depression, grief, PTSD, burnout, etc.), and you’ll have a clinician, guide, and peer community available to help you along the way. Patients also receive a starter kit (“Bloombox”) — similar to those from both Innerwell and Better U — that contains a journal, a welcome guide, an eye mask, and a blood pressure monitor.

To learn more about Mindbloom, check out our full review.

Mindbloom ketamine therapy pricing details

As we’ve mentioned previously in this guide, Mindbloom is the most expensive online ketamine therapy service of our top picks. Currently, there are three purchasing options available for new clients and two for returning ones. Here’s how the pricing breaks down (tablets and injectables cost the same):

For some reason, Mindbloom doesn’t offer the 12-session treatment option for returning clients. If 12 is what you’d like, you’ll have to purchase two six-session treatments back-to-back for $1,908 total. This is still less than the 12-session price for new clients, but it’d be nice to see the option offered for returning patients, too.

We'd like to point out that Mindbloom requires customers to pay the first installment of whatever plan they’re signing up for at checkout — even before going through the evaluation appointment. All of our other picks offer free evaluation appointments to see if you’re eligible for treatment. Mindbloom will refund your installment if you don’t qualify, but that’s still a lot of money. Also, it’s important to clarify that the installments are not the same as the costs per session detailed in the chart above; clients pay for two sessions per installment. Here’s how the installment prices for a new client work out:

• 6-session: $418 per month for three months
• 12-session: $358 per month for six months
• 18-session: $318 per month for nine months

This means that no matter which program you want to try, you’ll have to have at least $318 available just to book an evaluation to see if you can move forward with Mindbloom.

In terms of insurance, Mindbloom’s website is a bit deceptive at first glance. On the pricing information page, there’s a collection of insurance company logos and text stating that you can “save as much as $1,150 with insurance” — but the service does not accept any insurance plans. Further down the page, Mindbloom explains that patients may (emphasis on “may”) be able to get up to $1,150 back through reimbursement. Similarly, Mindbloom notes that HSA/FSA funds may be usable toward the costs of treatment.

Best very-low-dose ketamine therapy

Out of all our top picks for ketamine therapy, Joyous is perhaps the most unique. It’s a bit similar to Mindbloom in that it only offers ketamine therapy, but Joyous’ approach is far less structured than competitors’. Patients do have to complete daily text-based check-ins (along with their daily ketamine dose), but the treatment process is a very independent journey. Moreover, another differentiating aspect of Joyous is that its ketamine doses are considered very-low-dose or “psycholytic.”

The authors of a 2022 research article explained: “Unlike psychedelic therapy, psycholytic therapy aims at a less deeply altered state, with less loss of core self-identity. It does not aim at a dissolution of the ego, but only at a temporary change or softening of ego experience.”41 Basically, the lower doses used in psycholytic therapy shouldn’t lead to the same sort of dissociative experience that often comes with psychedelic therapy (using higher doses). This is why Joyous doesn’t require patients to have a sitter or guide with them during daily treatment sessions.

Interestingly, both the aforementioned article and information from other psychedelic therapy experts note that psycholytic therapy is supposed to go hand-in-hand with psychotherapy. The idea is that the patient remains aware or “in the moment” but also becomes able to process things from a different perspective, access repressed memories, and so on.41 42 If psychotherapy can play a key role in helping patients undergoing psycholytic ketamine therapy, we hope to see Joyous eventually add that into its treatment plan, either as an add-on or through a partnership with another platform.

Joyous ketamine therapy pricing

Joyous only offers one plan for ketamine therapy: $129 per month (30 daily troches; $4.30 each), no commitment necessary. This makes it the least expensive service in this guide by far, but it’s important to remember a few key things:

• The ketamine doses from Joyous are much lower and far less researched.
• You don’t get any extras like a starter kit (e.g., journal, blood pressure monitor, etc.).
• You won’t have as much support or structure as you would with other platforms.
• Although psychotherapy could improve psycholytic therapy outcomes, no psychotherapy is offered through Joyous.

However, if you feel like an independent approach suits your needs, or if you’d simply prefer very-low-dose ketamine therapy, then Joyous could certainly be a good fit for you.

During treatment, if you feel that adding talk therapy into the mix could benefit you, as research indicates it can, our guide to the best online therapy can help you get started. Alternatively, you could consider signing up for the psychotherapy options offered by Innerwell or Better U (if they’re available in your state) since their providers most likely have experience working with ketamine therapy patients.

At the time of this writing, there are two main alternatives to telehealth ketamine therapy services: Spravato nasal spray and in-person ketamine therapy infusion clinics. Let’s go over how these options differ from the services in this guide, including how they may better suit some people’s needs.

Spravato nasal spray

If you’re suffering from treatment-resistant depression (TRD) and you have health insurance, then it may be worth investigating whether or not your plan covers the FDA-approved nasal spray Spravato.

Traditional ketamine (ketamine hydrochloride) is made up of two “mirror-image” molecules: arketamine and esketamine. Spravato, in contrast, only contains the latter molecule, esketamine.9 Clinical trials have found that intranasal esketamine can “provide significant short-term symptom improvement in TRD, with only transient and mild-to-moderate side effects” experienced by most patients.44

However, a 2024 review noted that arketamine (the other molecule) “exhibits superior and longer-lasting antidepressant effects” compared to esketamine in animal models of depression.45 Similarly, another 2024 review explained that esketamine offers more potent analgesic and anesthetic effects, while arketamine performs better as an antidepressant and anti-inflammatory treatment.46 Unfortunately, at the time of this writing, research on the safety and effectiveness of arketamine alone in human patients with depression is very limited.45 As the science develops, we’ll update this information accordingly.

In-person ketamine therapy infusion clinics

For some people, going to a ketamine therapy infusion clinic may be the best course of action. This could be the case for individuals whose states aren’t served by online platforms or for those who don’t have a suitable person in their support network to act as a sitter during treatments.

Unfortunately, in-person ketamine therapy tends to be far more expensive than telehealth (including Mindbloom, the priciest online service in this guide). This is most likely because brick-and-mortar businesses also need to cover costs for the physical location, staff, equipment, and so on. But for people who need extra hands-on support during ketamine therapy, don’t have a treatment sitter, or who would just prefer having medical professionals close by, the higher investment may be worthwhile.