A different mechanism. A different result.
Most psychiatric medications target monoamine neurotransmitters — serotonin, norepinephrine, dopamine. Ketamine works through an entirely different system: glutamate, the brain's primary excitatory neurotransmitter and the most abundant chemical messenger in the nervous system.
Here's the simplified version of what happens:
Step 1: NMDA receptor blockade. Ketamine temporarily blocks NMDA receptors on inhibitory interneurons. These are the neurons that normally put the brakes on glutamate signaling. When ketamine blocks them, there's a brief surge of glutamate activity in key brain regions.
Step 2: AMPA receptor activation. That glutamate surge activates AMPA receptors, which triggers a signaling cascade inside the neuron. This cascade activates mTOR (a protein that controls cell growth) and releases BDNF — brain-derived neurotrophic factor.
Step 3: Neuroplasticity. Within hours, new dendritic spines begin forming in the prefrontal cortex. These are the physical connections between neurons that allow them to communicate. This is why patients often describe a sense of "lifting" or "opening" after an infusion — the brain is literally making new connections.
This entire process can begin within hours of a single infusion. SSRIs, by comparison, take 4-8 weeks to begin promoting neuroplasticity, and they do so through a much less direct pathway.
You'll arrive at Music City Ketamine in Franklin, TN about 15 minutes before your infusion. Marla Peterson, CRNA will review your medical history, answer questions, and walk you through what to expect. You'll settle into a private suite with a recliner.
Your private suite is fully sanitized between every session — fresh linens, hospital-grade cleaning protocols, one patient at a time. Weighted blanket, eye mask, and calming music are available — most patients find these helpful. The lights are low. Walter White, our Director of Hugs, may wander in with his laid-back surfer energy. Wilma, our Director of Aggressive Affection, will find you whether you're ready or not.
Before your IV is placed, Marla applies a topical numbing agent and uses an ultra-small gauge needle — her anesthesia training means the IV placement is quick, gentle, and most patients say they barely felt it. Once the line is in, the infusion begins. Mental health sessions are typically 40-50 minutes; chronic pain sessions range from 1-4 hours. You'll remain conscious throughout. Most patients describe a gentle sense of calm and mild dissociation — like being slightly removed from your usual thought patterns.
Marla Peterson, CRNA — with 20+ years of anesthesia experience — monitors your vitals and response throughout. The IV delivery allows precise dose adjustments in real time. This is a medical treatment administered by a licensed anesthesia professional under physician supervision.
After the infusion, you'll rest for about 30 minutes as the effects gently subside. Most patients feel clear-headed within an hour. You'll need a ride home — no driving on infusion day. Many patients notice mood improvements within hours; others feel the shift the next morning.
Not all ketamine delivery methods are equal. The route of administration significantly affects how much medication reaches the brain and how precisely it can be controlled.
| Factor | IV Ketamine (Music City Ketamine) |
Oral / Sublingual (At-Home) |
Nasal Spray / Spravato (Esketamine) |
|---|---|---|---|
| Bioavailability | 100% | 15-32% | 25-50% |
| Dose Control | Real-time adjustment | Fixed dose, no adjustment | Limited flexibility |
| Medical Monitoring | CRNA throughout | Unsupervised | In-office supervision |
| Onset | Minutes | 30-60 minutes | 15-30 minutes |
| Dosing Flexibility | Fully customizable | Standard doses only | Fixed dose options |
| Evidence Base | Decades of research | Emerging | FDA-approved (limited) |
| Molecule | Racemic (R + S ketamine) | Racemic (variable absorption) | S-ketamine only |
The standard protocol for depression, anxiety, PTSD, OCD, and other mental health conditions is 6 infusions over 2-3 weeks. Sessions are typically scheduled 2-3 times per week. Each infusion is 40-50 minutes, with about 90 minutes total visit time.
Many patients feel improvement after the first or second infusion. The series of 6 allows for cumulative neuroplastic changes that build on each other. After the initial series, maintenance infusions are scheduled based on your individual response — some patients return monthly, others every few months.
Pain protocols involve longer individual sessions — ranging from 1 to 4 hours — to achieve the central sensitization reset that chronic pain conditions require. The number and frequency of sessions depends on your specific condition.
Mental wellness sessions: $475 per session. Chronic pain: $475/1hr, $845/2hr, $1,100/3hr, $1,425/4hr. Music City Ketamine provides a superbill for out-of-network insurance reimbursement. Financing through Advance Care is available.
No. Spravato is a nasal spray containing only esketamine (one mirror-image molecule of ketamine). IV ketamine at Music City Ketamine uses racemic ketamine — both the R and S forms — delivered intravenously for 100% bioavailability and real-time dose control. IV ketamine offers greater dosing flexibility and has a broader evidence base.
Mental health infusions are typically 40-50 minutes, with a total visit time of about 90 minutes. Chronic pain infusions range from 1-4 hours depending on the protocol. Marla Peterson, CRNA at Music City Ketamine in Franklin, TN determines the optimal duration based on your specific condition and response.
Most patients describe a deep sense of calm and mild dissociation — a feeling of being slightly removed from your surroundings. Some experience gentle visual effects with eyes closed. You remain conscious throughout and can communicate with your provider. The experience is carefully managed in a private suite with a weighted blanket, eye mask, and calming music.
No. You will need someone to drive you home after your session. The dissociative effects resolve within 1-2 hours, but it is not safe to operate a vehicle on the day of your infusion. Plan to rest for the remainder of the day.
A consultation is a conversation — not a commitment. Let's talk about your situation and whether ketamine therapy at Music City Ketamine in Franklin, TN might be the right fit.
Schedule a Conversation Text (615) 988-4600