IV ketamine for Delray Beach — psychiatry-supervised, integrated with therapy.

RECO Health's Delray Beach campus at 140 NE 4th Avenue is a zero-mile drive for local residents — three minutes from Pineapple Grove, five from Lake Ida. IV ketamine is delivered here by the same psychiatry team that manages your medication regimen and coordinates integration therapy the day after each infusion, in a monitored clinical setting with continuous vitals and CADSS-assessed dissociation. Both IV racemic ketamine and Spravato are available, and the choice is made clinically during the consult rather than dictated by whichever modality the site happens to offer.

RECO Health’s Delray Beach campus sits at 140 NE 4th Avenue, one block off Atlantic and a five-minute walk to the sand. For residents of Pineapple Grove, Lake Ida, Tropic Isle, and the Beach District, treatment-resistant depression does not require flying to a research center in Boston or Houston — IV ketamine therapy is delivered on-site by the same psychiatry team that manages the medication regimen, in a monitored clinical setting, with integration therapy scheduled the day after each infusion.

Why ketamine works when SSRIs have not

Ketamine is a non-competitive NMDA receptor antagonist. That mechanism sits on a different axis from the SSRIs, SNRIs, and atypical antidepressants that make up standard first- and second-line care for major depressive disorder. Where sertraline, escitalopram, venlafaxine, and bupropion act on monoamine reuptake and produce measurable symptom change over four to six weeks, ketamine’s antidepressant effect emerges within hours to days through downstream AMPA receptor signaling, increased BDNF release, and rapid synaptogenesis in prefrontal circuits blunted by chronic stress.

The speed matters clinically for two populations. The first is treatment-resistant depression — patients with a PHQ-9 above 15 who have failed at least two adequate antidepressant trials at therapeutic dose and duration, often with augmentation by aripiprazole, quetiapine, or lithium. The second is acute suicidality, where a six-week wait on a new SSRI is not an available option. Ketamine belongs in both pathways not as a first-line agent but as the intervention that works on the timeline the clinical situation requires.

PTSD refractory to prolonged exposure or EMDR is a third indication where the mechanism is under active investigation, with response rates in the published literature high enough that RECO’s psychiatry team will consider a trial when trauma-focused therapy has stalled and the client remains symptomatic on sertraline or paroxetine.

The 40-minute infusion and the six-session induction

A single session runs roughly two hours end-to-end. Intake vitals and a pre-infusion check-in take about fifteen minutes. The infusion itself is 0.5 mg/kg dosed by lean body weight, delivered intravenously over 40 minutes with continuous blood pressure, heart rate, and pulse oximetry. Dissociative symptoms are assessed with the CADSS during and after the infusion; dose is occasionally titrated on subsequent sessions based on prior response, tolerability, and dissociation profile. Post-infusion recovery runs 30 to 60 minutes in a monitored setting until the client is oriented, ambulatory, and cleared by the attending clinician.

Clients cannot drive after a session — every client arranges a ride home before the first infusion is scheduled. From most of Delray Beach, that is a five- to ten-minute drive.

The induction protocol is six infusions across two to three weeks. That interval is not arbitrary. It reflects the point on the clinical curve where sustained response either consolidates or fails to — patients who show clear PHQ-9 movement by the third or fourth infusion typically continue to respond through session six and enter a maintenance phase, while patients with no response by session four are re-evaluated for alternative pathways including Spravato, rTMS at 3000 pulses per session at 120% of motor threshold, or a return to combination pharmacotherapy.

Integration therapy is what makes response durable

Ketamine opens a window. Therapy determines whether the client walks through it. The published literature on ketamine without structured integration shows shorter response duration and higher relapse rates than protocols that pair the infusion series with therapy. RECO’s protocol schedules integration sessions the day after each infusion, when the neuroplastic window is still open and the material that surfaced during the session is still accessible to conscious work.

The integration therapist is trained in ACT, CBT, and — where trauma is central — EMDR. The session is not psychedelic-assisted therapy in the classical psilocybin sense; ketamine’s dissociative profile is different. The therapeutic principle is the same: state-dependent insights are consolidated into behavior change during a defined post-session window, and without that consolidation the antidepressant effect tends to fade with the pharmacological one.

For clients whose depression is entangled with alcohol or opioid use disorder, integration also coordinates with the medication management team on buprenorphine, naltrexone, or acamprosate. Ketamine is not a substitute for MAT, and the psychiatry team will not run a full induction series in a client with untreated active substance use disorder — the presentation is stabilized first, using ASAM Criteria dimensions to place the client at the appropriate level of care.

IV ketamine versus Spravato — how the decision is made

Two forms of ketamine are available for treatment-resistant depression. IV racemic ketamine is used off-label, cash-pay in most cases, with dose flexibility and a compressed induction schedule. Spravato (esketamine) is FDA-approved for TRD and covered by most commercial plans — Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS — under a REMS protocol requiring in-office administration and a two-hour post-dose observation window.

The clinical trade-offs are real. Spravato’s twice-weekly schedule for the first four weeks is more disruptive to work and family than six IV infusions across two to three weeks. IV ketamine allows fine dose titration in a way esketamine’s fixed 56 mg and 84 mg intranasal doses do not. Response quality is comparable in the head-to-head literature but individual response varies. Insurance coverage frequently decides the question — a several-hundred-dollar-per-session IV series without insurance is not accessible for every family.

Both modalities are available at RECO. The decision is made during the psychiatry consult based on prior treatment history, insurance status, response to any previous ketamine or esketamine exposure, and the client’s scheduling constraints.

What to expect on your first visit

The first visit is a full psychiatric consult — typically 60 to 90 minutes — with the physician who will supervise the ketamine series. It is not the first infusion. The consult confirms the working diagnosis, reviews prior medication trials and their PHQ-9 or GAD-7 trajectories, screens for contraindications (uncontrolled hypertension, active psychosis, unstable cardiac disease, active substance use, pregnancy), and establishes the treatment plan.

Clients bring a current medication list, prior prescriber records where available, and any recent labs. An ECG is obtained if one is not on file. The first infusion is typically scheduled within a week of the consult, contingent on clearance, and the integration therapist is introduced at the same visit so the day-after session is on the calendar before the induction begins.

Insurance, admissions, and the drive from Delray Beach

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BCBS for the psychiatric consult, Spravato administration, and the integration therapy component. IV racemic ketamine itself is billed cash-pay in most cases because reimbursement for off-label IV administration remains inconsistent — the admissions team runs a full verification of benefits before the consult so cost is not a surprise at session one.

The campus is a zero-mile drive for anyone already in Delray Beach — three minutes from Pineapple Grove, five from Lake Ida, seven to ten from Tropic Isle and Osceola Park, and walkable from most of the Beach District. Admissions is reached seven days a week and typically completes verification and scheduling within one business day.

Serving residents of: Pineapple Grove, Lake Ida, Tropic Isle, Beach District, Osceola Park.