Ketamine for Treatment-Resistant
Depression in Baltimore
When antidepressants haven't worked — a different mechanism, rapid onset, one clinic
Ketamine for treatment-resistant depression Baltimore costs $499.99 per session ($375 for Vitality Circle members) and is an off-label IV infusion for major depression that hasn't responded adequately to at least two antidepressants of adequate dose and duration. About 30% of people with major depression meet that definition. Ketamine works through NMDA-receptor blockade and rapid synaptogenesis rather than the monoamine system every antidepressant you've already tried acts on — which is why it can produce relief within hours rather than weeks, and why it can work when those medications did not. Every infusion is delivered as anesthesiologist-led care, under the medical direction of Dr. Brijen Joshi MD, a Johns Hopkins anesthesiologist, with a Certified Registered Nurse Anesthetist (CRNA) on-site. Self-pay with an itemized superbill you can file with your insurance; not everyone is a candidate, and you'll be told clearly after evaluation.
"The team is extremely professional, compassionate and knowledgeable — they take the time to explain the process thoroughly and care about your well-being throughout." — Google review, Vita Nova patient
Founder & Medical Director, Vita Nova · Johns Hopkins Faculty Physician · Assistant Professor, Anesthesiology & Critical Care Medicine · Chief, Thoracic Anesthesia, Johns Hopkins Hospital · Board-Certified Anesthesiologist
Mon–Fri: 1PM–8PM · Sat: 10AM–2PM
513 Bayview Blvd, Canton, Baltimore MD 21224
(443) 563-1059
Tell Us About Your Situation
Answer a few quick questions — our clinical team reaches out within 1 business day to discuss whether ketamine therapy may be right for you.
Your information is confidential. A clinical team member follows up within 1 business day.
What Is Treatment-Resistant Depression?
Treatment-resistant depression (TRD) is defined as major depressive disorder (MDD) that has not responded adequately to at least two antidepressant medications of adequate dose and duration during the current depressive episode.
TRD is not a character failing or a sign that depression cannot be treated — it is a clinical classification that reflects the biological complexity of depressive disorders and the limitations of existing pharmacological approaches for a significant subset of patients.
An estimated 30% of patients with major depression do not achieve remission after multiple antidepressant trials. These patients often cycle through medications for years — adjusting doses, switching agents, adding augmentation strategies — with each failure increasing the burden of illness, lost productivity, relationship strain, and in some cases, suicidal ideation.
The emergence of ketamine as a care pathway represents a genuine clinical advance for TRD — not because it works for everyone, but because it acts through an entirely different mechanism than every prior antidepressant class, and it does so with a speed of onset that no previous antidepressant has achieved.
Symptoms that may indicate TRD
TRD is a clinical classification, not a symptom set — but the following experiences are common among patients who meet TRD criteria: persistent low mood lasting weeks or months without meaningful periods of relief; anhedonia — the inability to feel pleasure from activities previously enjoyed; profound fatigue and psychomotor slowing; cognitive symptoms including concentration difficulty and memory disruption; hopelessness about the future, including passive or active suicidal ideation; and significant functional impairment affecting work, relationships, and daily life — despite ongoing mental-health care and multiple medication trials.
🆘 If you are experiencing thoughts of self-harm, call or text 988 (Suicide & Crisis Lifeline) now, or go to your nearest emergency room.
How Ketamine Works — vs. What You've Already Tried
Every antidepressant you have tried — SSRIs, SNRIs, TCAs, MAOIs, atypical antidepressants — modulates the monoamine system. Ketamine operates through a completely different pathway. For patients with TRD, this mechanistic difference is the reason ketamine may work when every prior treatment has not.
- Target monoamine neurotransmitters — serotonin (SSRIs/SNRIs), norepinephrine, dopamine
- Require 2–8 weeks of daily dosing before meaningful effect
- Do not address glutamate dysfunction or synaptic structural changes associated with depression
- Response rates drop significantly with each failed trial — after 2 failures, remission rates fall below 20%
- Cannot restore synaptic connections that depression has pruned
- Blocks NMDA receptors — targeting the glutamate system, not the monoamine system
- Rapidly increases glutamate signaling, activating AMPA receptors and triggering BDNF release
- Promotes synaptogenesis — formation of new synaptic connections in prefrontal and limbic circuits
- Antidepressant effects appear within hours to days — not weeks
- Addresses the structural synaptic changes that standard antidepressants cannot reverse
References: Duman RS, Aghajanian GK (2012). Synaptic dysfunction in depression: potential therapeutic targets. Science 338(6103):68–72. · Castrén E, Monteggia LM (2021). Brain-derived neurotrophic factor signaling in depression and antidepressant action.
The Research Behind Ketamine for TRD
Ketamine's use for treatment-resistant depression is supported by more than two decades of peer-reviewed clinical research published in leading peer-reviewed journals.
All clinical evidence cited is from peer-reviewed publications. Ketamine infusions for TRD remain off-label. Individual results vary. Not all patients respond.
What an IV Ketamine Series Looks Like for TRD
One of the most common questions before starting is simply: what actually happens? Here is the pathway most TRD patients follow at Vita Nova — from the first evaluation through a full induction series and into maintenance.
Most TRD protocols use 4 to 6 infusions over 2 to 3 weeks, mirroring the clinical-trial schedules that produced the strongest results. This concentrated series is designed to establish and consolidate a response before any maintenance plan is considered.
Each infusion runs roughly 40–60 minutes in a private, comfortable setting. Most patients experience a mild, transient dissociative state during the infusion, which resolves shortly afterward. You rest, you are monitored, and you go home the same day.
Blood pressure, heart rate, and your overall response are monitored throughout each session. A brief recovery period follows every infusion. You will need someone to drive you home — you should not drive for the rest of that day.
Your full history and prior medication trials are reviewed before any infusion. All care is anesthesiologist-led care, under the medical direction of Dr. Brijen Joshi MD, a Johns Hopkins faculty anesthesiologist. More on ketamine therapy →
Pricing for TRD Treatment at Vita Nova
Ketamine for TRD is off-label. Ketamine at Vita Nova is self-pay — you pay directly, and we provide an itemized superbill you can file with your insurance. HSA and FSA cards are accepted for the full cost, a member plan brings the per-session rate down, and Community Heroes discounts apply for veterans and first responders. Every infusion is anesthesiologist-led, under the medical direction of Dr. Brijen Joshi MD, a Johns Hopkins faculty anesthesiologist in a private room with continuous monitoring — that physician-level care is what the per-session price reflects.
| Treatment | Non-Member | Vitality Circle Member | Saving |
|---|---|---|---|
| Ketamine Infusion — per session Off-Label | $499.99 | $375 | $124.99/session |
| Complete Series — 6 infusions · includes 3 complimentary hydration IVs Off-Label | $2,849.94 | $2,250 | $599.94 |
| 🦅 Community Heroes Discount | Available for veterans, first responders, teachers, nurses, seniors — confirm at booking | ||
Self-pay, with a superbill. Vita Nova is self-pay for ketamine. We provide an itemized superbill you can file with your insurance for possible out-of-network reimbursement. HSA and FSA cards accepted; Community Heroes discounts available. Pricing August 2026 — subject to change. Full pricing guide →
Complementary Treatments Alongside Ketamine for TRD
Several wellness services available at Vita Nova address nutrient depletions and biological deficits commonly seen in patients with treatment-resistant depression. These are general wellness services, not treatments for depression. Vitality Circle members receive significant discounts on all of the below.
NAD+ supports cellular energy production, mitochondrial function, and neurological health. NAD+ levels are significantly depleted in patients with chronic depression and long-term antidepressant use.
Members: 25% off all dosesMagnesium is a natural NMDA receptor modulator — directly relevant to ketamine's mechanism. Magnesium deficiency is common in depression and is associated with increased NMDA receptor sensitivity.
✅ Included for Vitality Circle members (2 shots/month)B12 deficiency — common in patients on metformin, PPIs, or long-term SSRIs — contributes to fatigue, cognitive fog, and mood disturbance. IM delivery achieves immediate bioavailability.
✅ Included for Vitality Circle members (2 shots/month)Iron is a cofactor for tyrosine hydroxylase — the rate-limiting enzyme in dopamine synthesis — so iron-deficiency anemia can deepen the fatigue, low motivation, and anhedonia seen in depression. IV iron restores stores faster than oral iron when deficiency is confirmed on bloodwork.
Members: 25% offClinical note: The complementary treatments above are general wellness services, not treatments for depression and not part of Vita Nova's clinical ketamine protocol. Always discuss any additional supplements or IV therapy with your prescribing physician before beginning.
Veterans, First Responders & Community Heroes
Treatment-resistant depression is not evenly distributed. Veterans, active service members, first responders, teachers, nurses, and frontline workers face disproportionately elevated rates of TRD — often alongside PTSD, moral injury, and occupational burnout that standard antidepressant approaches were not designed to address.
Why this matters for TRD: Veterans and first responders experience TRD at rates significantly higher than the general population — driven by PTSD, moral injury, cumulative trauma, and the emotional toll of service. Many have already tried multiple antidepressants without success. The Community Heroes program exists because the clinical need is highest in these groups, and the financial barrier should be lowest.
TRD & Ketamine — Questions Answered
Common questions from patients evaluating ketamine therapy for treatment-resistant depression in Baltimore.
🆘 In a mental health crisis, call or text 988 (Suicide & Crisis Lifeline) now, or go to your nearest emergency room.
If Two Antidepressants
Haven't Been Enough —
A different mechanism may make a different difference. Start with a telemedicine consultation — your provider reviews your full history and prior medication trials before any recommendation is made. All care is anesthesiologist-led, under the medical direction of Dr. Brijen Joshi MD. Self-pay with an itemized superbill you can file with your insurance. Community Heroes discounts available for veterans and first responders.
Canonical URL: https://vitanovawellnessclinic.com/ketamine-trd-baltimore/ · Last reviewed August 2026
Medically reviewed by Dr. Brijen L. Joshi MD — Assistant Professor of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine · Chief of Thoracic Anesthesia, Johns Hopkins Hospital · Medical Director, Vita Nova Ketamine & Wellness Clinic. · View full team →
