IV ketamine for Fort Lauderdale — psychiatry-supervised, integrated with therapy.

RECO Health's Delray Beach campus is 26 miles and about 40 minutes north of Fort Lauderdale on I-95 — close enough that Las Olas and Victoria Park clients can complete a full six-infusion ketamine induction without relocating. Ketamine at RECO is a psychiatry-supervised medical treatment: 0.5 mg/kg racemic ketamine over 40 minutes, continuous vitals monitoring, CADSS-scored recovery, and integration therapy the day after each session using CBT, ACT, or EMDR matched to the presenting problem. Both IV ketamine and Spravato (esketamine) are available in-house, and the choice is made with the psychiatrist based on TRD criteria, response history, and insurance coverage.

For clients living around Las Olas, Victoria Park, Coral Ridge, Rio Vista, or Wilton Manors, RECO Health’s Delray Beach campus sits 26 miles north on I-95 — a 40-minute drive that keeps a full six-infusion ketamine induction accessible without requiring anyone to relocate. The distance is intentional: close enough that Fort Lauderdale clients keep working and sleeping at home, far enough that the clinical environment is separated from the neighborhoods and relationships tied to depression, PTSD, or active use. Ketamine at RECO is a psychiatry-supervised medical treatment integrated with therapy, not a walk-in infusion service.

Ketamine’s mechanism and why it works fast

Ketamine is a non-competitive NMDA receptor antagonist. The clinical antidepressant effect appears to be driven downstream — through a surge in glutamate signaling at AMPA receptors, release of brain-derived neurotrophic factor (BDNF), and rapid synaptogenesis in prefrontal circuits implicated in mood regulation. That mechanism is fundamentally different from SSRIs and SNRIs such as sertraline, escitalopram, or venlafaxine, which act on monoamine reuptake and generally require four to six weeks to produce a measurable change in PHQ-9 score.

The practical consequence is speed. In patients who respond, ketamine’s antidepressant and anti-suicidal effect emerges within hours to days rather than weeks. That single fact is why IV ketamine therapy belongs in the treatment-resistant depression pathway — defined as failure to respond to two adequate trials of first-line antidepressants, often after augmentation with lithium, aripiprazole, or quetiapine — and in the acute-suicidality pathway, where a six-week medication trial is not a clinically acceptable time horizon. Ketamine is not a first-line agent. It is what psychiatry reaches for when the standard sequence has failed or when the clock is short.

The 40-minute infusion, monitored recovery, and six-session induction

Each session runs roughly two hours end-to-end. The clinical team takes intake vitals, confirms medications and NPO status, then initiates a 40-minute infusion of racemic ketamine at 0.5 mg/kg — weight-adjusted, with occasional titration up or down based on tolerability and response from prior sessions. Blood pressure, heart rate, and oxygen saturation are monitored continuously by a nurse. Dissociative symptoms are assessed with the Clinician-Administered Dissociative States Scale (CADSS), and any transient hypertensive response is managed on-site.

After the infusion, clients spend 30 to 60 minutes in monitored recovery until sensorium and vital signs return to baseline. Driving is prohibited that day; a family member, rideshare, or RECO-coordinated transport takes the client home. The induction protocol is six infusions across two to three weeks — the interval where response either consolidates or does not. PHQ-9 and C-SSRS scores are tracked before and after each infusion, and treatment is formally reassessed at session three and again at session six. Maintenance boosters, when indicated, are scheduled based on observed response duration for that specific client — typically every three to six weeks initially, then extended as tolerated.

Integration with psychotherapy makes response durable

Ketamine opens a window; therapy determines whether the client walks through it. RECO’s protocol pairs the infusion series with structured integration sessions — typically the day after each infusion — where a therapist works with the material that surfaced during the dissociative period and consolidates cognitive and emotional shifts into durable change. The evidence is unambiguous on this point: infusions delivered without therapeutic integration produce shorter response durations and higher relapse rates than infusions paired with an active psychotherapy course.

The modality is matched to the presenting problem. For treatment-resistant depression, integration draws on cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT), targeting the rumination and hopelessness cognitions that predict relapse. For PTSD refractory to first-line care, integration is often paired with EMDR or trauma-focused CBT, using the post-infusion window to reprocess trauma material with reduced avoidance. When depression sits alongside substance use, motivational interviewing (MI) and DBT skills training round out the treatment plan, with buprenorphine or naltrexone managed by the same psychiatrist supervising the infusions.

Ketamine versus Spravato — how the decision is made

IV ketamine is off-label and, in most cases, cash-pay. Spravato (esketamine), the intranasal S-enantiomer, is FDA-approved for treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. It is covered by most commercial insurance under a Risk Evaluation and Mitigation Strategy (REMS) protocol that requires administration in a certified clinic with two hours of on-site monitoring after each dose.

The choice between them is clinical and financial. Spravato tends to be the right answer when insurance coverage is the deciding factor and the standard schedule — twice weekly for four weeks, then weekly or every-other-week maintenance — is workable for the client’s job and family logistics. IV ketamine tends to win when dose flexibility, response quality, or a compressed two-to-three-week induction is the higher priority, or when a client has had a partial response to esketamine and needs the therapeutic ceiling that IV allows. RECO offers both. The decision is made with the psychiatrist during the initial consult, after the TRD criteria and full medication history have been reviewed.

What to expect on your first visit

The first appointment is a psychiatric evaluation, not an infusion. The psychiatrist takes a full history, confirms the treatment-resistant depression or PTSD diagnosis under DSM-5 criteria, and reviews prior medication trials — sertraline, escitalopram, bupropion, venlafaxine, mirtazapine, augmentation with lithium or aripiprazole, and any prior TMS or ECT — to confirm that adequate dose and duration were reached before non-response was declared. Baseline PHQ-9, GAD-7, and C-SSRS scores are collected, and comorbid anxiety, OCD (YBOCS), or adult ADHD (ASRS) are screened when clinically indicated.

Medical clearance follows. Contraindications to IV ketamine include uncontrolled hypertension, active psychosis, unstable cardiovascular disease, and pregnancy; a substance use history is not a contraindication but shapes the treatment plan and, when relevant, is assessed against ASAM Criteria dimensions. Vitals, an ECG when indicated, and a focused physical are completed the same day. If the client is cleared, the first infusion is typically scheduled within one to two weeks, and the integration therapist is assigned before the induction begins.

Insurance and admissions from Fort Lauderdale

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and most Blue Cross Blue Shield plans. For the ketamine service specifically, insurance typically covers the psychiatric evaluation and the integration therapy under standard behavioral health benefits. Spravato is generally covered under pharmacy or medical benefits with prior authorization. IV ketamine infusions themselves are typically cash-pay; admissions provides a written estimate before the induction series begins so cost is not a mid-course surprise.

The logistics from Fort Lauderdale are straightforward. From Las Olas or Victoria Park, the drive is about 40 minutes up I-95 to the Atlantic Avenue exit; Coral Ridge and Wilton Manors clients add a few minutes, Rio Vista clients trim them. Because clients cannot drive after an infusion, RECO helps coordinate transportation for the induction series, and the treatment schedule is built around Fort Lauderdale work commutes wherever possible.

Serving residents of: Las Olas, Victoria Park, Coral Ridge, Rio Vista, Wilton Manors.