If you've spent years cycling through antidepressants and waiting weeks to see if each one works, you're not alone. Ketamine works differently. Most patients feel something shift within hours or a few days of their first infusion, not the typical four to six week wait.
IV ketamine therapy is a fast-acting, evidence-based treatment for treatment-resistant depression, severe anxiety, PTSD, and acute suicidal ideation. Originally developed as a safe anesthetic in the 1960s, ketamine at low sub-anesthetic doses has been studied since the early 2000s for its rapid antidepressant effects. Today it's one of the most-researched alternatives for patients who haven't responded to traditional medication.
At Better Balance Psychiatry, IV ketamine is administered in our St. George and Cedar City offices by board-certified psychiatrists, not anesthesiologists alone. That clinical context matters: ketamine for depression is a psychiatric treatment, and the right diagnosis, dose, and follow-up plan come from psychiatric expertise.
Communities We Serve
IV ketamine treatment is available at our St. George and Cedar City clinics. Patients travel to us from St. George, Cedar City, Hurricane, Ivins, Washington, Santa Clara, Parowan, Enoch, Brian Head, New Harmony, La Verkin, Toquerville, Kanab, Mesquite, and across southern Utah. Initial psychiatric evaluations are available by telehealth for patients anywhere in Utah.
Traditional antidepressants like SSRIs work by raising serotonin levels in the brain, a process that takes weeks. Ketamine works on a completely different system, which is why it can act so much faster.
Ketamine is an NMDA receptor antagonist. By temporarily blocking these receptors, it triggers a surge of glutamate, the brain's primary excitatory neurotransmitter. This glutamate surge promotes the release of BDNF (brain-derived neurotrophic factor), a protein that supports the growth and strengthening of new neural connections.
In depression, brain imaging consistently shows reduced connectivity in mood-regulating regions, particularly the prefrontal cortex. Ketamine appears to rapidly restore that connectivity by promoting synaptic plasticity, the brain's ability to form new pathways. For many patients, this translates into noticeable mood improvement within hours or days, sometimes after a single infusion.
At Better Balance Psychiatry, each infusion is delivered at a carefully calculated sub-anesthetic dose, typically 0.5 to 1.0 mg/kg, over 40 to 60 minutes. You remain conscious and able to communicate throughout, with continuous monitoring by our medical team.
We walk every patient through the same clear path. No surprises, no hidden steps.
You meet with a board-certified psychiatrist for a full psychiatric assessment, including diagnosis, medical history, current medications, and treatment goals.
We calculate your individual dose based on body weight, medication interactions, and clinical presentation. Standard induction is six infusions over two to three weeks.
Each session is delivered in a private, comfortable treatment room. The infusion runs 40 to 60 minutes with continuous monitoring of your vital signs by our medical team.
A brief recovery period after the infusion, then your driver takes you home. We follow up between sessions and after the series to track progress and plan maintenance if needed.
Most ketamine clinics in Utah are run by anesthesiologists. Ours are supervised by board-certified psychiatrists. For depression and anxiety, psychiatric expertise is the foundation, not an add-on.
The region voted us Best Psychiatrist in 2023. We've been the destination practice for advanced psychiatric care across St. George and Cedar City.
Vital signs are monitored from the start of your infusion through the recovery period. Our medical team is in the room with you throughout, not in another room watching a screen.
In-office treatment in both St. George and Cedar City. Patients travel from across southern Utah without driving four hours to Salt Lake.
We tell you exactly what your treatment will cost before you commit. HSA and FSA accepted. Self-pay terms reviewed during your consultation, with no surprise bills.
If IV ketamine isn't right for you, we offer Spravato, TMS, medication management, IOP, and therapy under one roof. You're not locked into one path.
Each option works through a different mechanism, with different timelines and tradeoffs. Here's how IV ketamine stacks up.
| IV Ketamine | Spravato | TMS Therapy | Antidepressants | |
|---|---|---|---|---|
| How it works | IV infusion modulates glutamate and NMDA receptors | Esketamine nasal spray, same mechanism as ketamine | Magnetic pulses stimulate underactive brain regions | Systemic medication adjusts brain chemistry through bloodstream |
| FDA status | Off-label for psychiatric use, FDA-approved as anesthetic | FDA-approved for treatment-resistant depression | FDA-cleared for depression, OCD, anxious depression | FDA-approved |
| Onset of relief | Hours to days | Hours to days | Two to four weeks into treatment course | Four to six weeks |
| Sessions required | 6 infusions over 2 to 3 weeks, then maintenance | Twice weekly for 4 weeks, then weekly, then biweekly | 36 sessions over 6 to 8 weeks | Daily, often for years |
| Insurance coverage | Usually self-pay (HSA / FSA accepted) | Widely covered by major insurance | Widely covered for treatment-resistant depression | Widely covered |
| Driver required | Yes, ride home required | Yes, observation period required | No, drive yourself home | No |
| Experience during treatment | Brief dissociation, conscious throughout | Brief dissociation, conscious throughout | Tapping sensation on scalp, fully alert | No immediate effect |
Not every treatment fits every patient. During your consultation we'll review your history and help you decide whether IV ketamine, Spravato, TMS, or another approach makes the most clinical sense.
Ketamine therapy is psychiatric care first, medical procedure second. The clinician supervising your treatment matters as much as the infusion itself.
Dr. Hendleman founded Better Balance Psychiatry to bring advanced, evidence-based care to southern Utah. He specializes in IV ketamine, Spravato, TMS, and complex medication management, with particular focus on treatment-resistant depression and trauma in uniformed service members.
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Dr. Nyberg specializes in trauma-informed care, attachment disorders, anxiety and mood disorders, ADHD, and advanced treatments including IV ketamine and TMS. His experience spans inpatient crisis stabilization, outpatient psychiatry, and adolescent residential care.
Learn MoreIV ketamine for depression is considered off-label, so it isn't typically covered by insurance. We accept the following:
If insurance coverage is essential, we also offer Spravato, an FDA-approved esketamine nasal spray that uses the same mechanism as IV ketamine and is widely covered by major insurance.
In-person IV ketamine treatment is available at both our St. George and Cedar City clinics. Both offices offer the same care team, the same clinical protocol, and the same transparent pricing.
Real reviews from across Southern Utah.
"The front staff are always super energized, upbeat, and welcoming. Kell is always on the go in the office making sure patients are taken care of while waiting for their appointment. The providers are respectful and caring."
"The staff at Better Balance in Cedar are always friendly and kind. Kale goes out of her way to make anyone feel welcome. The office staff are always ready to help and make you feel comfortable."
"I love Better Balance Psychiatry! The staff is so good at making you feel comfortable and welcoming. The providers also know their stuff and make sure to check in with you often. I'd highly recommend for anyone seeking help with their mental health."
"Everyone I've worked with in the office is absolutely amazing. I've had a wonderful experience every time. They're great at helping you feel comfortable. Very grateful for their team."
Ketamine is FDA-approved as an anesthetic. Its use for depression, anxiety, and PTSD at sub-anesthetic doses is considered off-label, but it's backed by more than two decades of clinical research. The related esketamine nasal spray, Spravato, is FDA-approved specifically for treatment-resistant depression, and we offer that as well.
No. The doses used for psychiatric treatment are far lower than anesthesia doses. You'll remain conscious and able to communicate throughout the infusion, though you may feel a sense of dissociation or altered awareness for the duration of the session. These effects fade shortly after the infusion ends.
When administered in a clinical setting at sub-anesthetic doses by a medical team, IV ketamine therapy has not shown the addictive patterns associated with recreational use. The structured, time-limited protocol of medical ketamine therapy is fundamentally different from chronic recreational exposure.
Many patients report mood improvements within hours to a few days after their first infusion. This rapid onset is one of the most distinctive features of ketamine compared to traditional antidepressants, which typically require 4 to 6 weeks to show effect. Most patients complete a series of 6 infusions over 2 to 3 weeks for sustained results.
IV ketamine for psychiatric conditions is generally considered off-label and is not typically covered by insurance. We accept HSA and FSA payments, offer transparent self-pay pricing, and can discuss financing options during your consultation. If insurance coverage is essential, we also offer Spravato, an FDA-approved nasal spray version of ketamine that is widely covered.
Cost varies based on your individual treatment plan and number of sessions. We provide transparent pricing during your initial consultation, including options for the initial 6-infusion series and ongoing maintenance. HSA, FSA, and major credit cards are accepted.
Most patients continue their existing antidepressants and anti-anxiety medications during ketamine therapy. Medication interactions with ketamine are rare. Your psychiatrist will review your full medication list during your initial evaluation and make adjustments only if clinically necessary.
Both contain ketamine, but they differ in route, FDA status, and coverage. Spravato is an esketamine nasal spray that is FDA-approved for treatment-resistant depression and widely covered by insurance. IV ketamine is a low-dose intravenous infusion used off-label, with rapid onset and a broader range of clinical applications. Many patients choose IV ketamine for its flexibility; others choose Spravato for insurance coverage.
Yes. You should not drive, operate machinery, or make important decisions for the rest of the day after treatment. We require all patients to arrange transportation home. Most patients feel back to normal by the following morning and can return to work.
Patients commonly describe a sense of mental quietness, mild dissociation, or a feeling of floating during the infusion. Some experience visual effects or shifts in perception. These sensations are part of the therapeutic experience and fade within 30 to 60 minutes of the infusion ending. You'll be in a private, comfortable room with our medical team throughout.
Schedule a confidential consultation with our psychiatric team. We'll review your history, explain your options, and let you know whether IV ketamine is the right fit. No referral required.
In-person treatment in St. George and Cedar City · Initial consults available by telehealth
