Injection
Tirzepatide + B12
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with vitamin B12 for energy.
Starting at $198/mo
DepressionTreatment-resistantRapid relief
Ketamine ODT (Orally Disintegrating Tablet)
RxPrescription onlyDissolved under the tongue · Once a day · 50–100 mg · Depression · Treatment-resistant · Rapid relief
Starting at $219/mo
Ketamine: dissociative anesthetic repurposed for treatment-resistant depression and severe depressive episodes. Sublingual (under-tongue) tablet for rapid onset. Strong emerging evidence; close physician oversight required.
How many tablets per month?
MonthlyEvery 3 months
30 tabletsper month
You'll receive 30 tablets per month. $249 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Rapid onset of action: relief within hours to days, not weeks
- Effective for treatment-resistant depression when SSRIs fail
- Dissociation managed by physician; dose and setting controlled
Every plan includes
- Personalized, physician-guided plan
- 30 tablets per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is ketamine for depression?
(racemic ketamine, NMDA receptor antagonist)
Ketamine is an NMDA receptor antagonist originally used for anesthesia. At sub-anesthetic doses, it produces rapid antidepressant effects distinct from SSRIs or MAOIs. The mechanism is not fully understood but involves NMDA antagonism, increased BDNF, and rapid synaptogenesis. Ketamine works within hours to days in treatment-resistant depression, whereas SSRIs take weeks. A sublingual form (orally disintegrating tablet) allows at-home dosing under physician guidance. Dissociation (feeling detached from body or surroundings) is expected; your physician prepares you.
- How it is taken
- Dissolved under the tongue
- How often
- Once a day
- Dose range
- 50–100 mg
- Form
- Depression · Treatment-resistant · Rapid relief
50-70%
response rate in treatment-resistant depression
Ketamine works when standard antidepressants do not. Doses range 0.5-1 mg/kg; sublingual forms are 2-10 mg. Response is rapid: hours to days, not weeks. Tolerance may develop with repeated use.
How it works,
week by week.
Day 1
Your physician reviews your depression history, failed antidepressant trials, psychiatric status, blood pressure, substance use history, and suicide risk. Discusses ketamine's rapid action, expected dissociation, and risks.
Week 1
First ketamine dose under physician supervision or in an office setting. Take as sublingual tablet. Expect dissociation (feeling detached, mild hallucinations) for 30-90 minutes. Rest and recover with a designated person.
Days 2-7
Mood and depression symptoms often lift significantly within 24-72 hours. Some people report euphoria; this fades. Continue your other psychiatric medications unless your physician advises otherwise.
Weeks 2-4
Your physician assesses your mood and response. Additional ketamine doses may be given on a schedule (e.g., weekly initially, then as-needed). Discuss maintenance and long-term plans.
Beyond
Ketamine is continued only if response is sustained and risk is acceptable. Your physician monitors your mental state, substance use risk, and continued need at every visit.
What you may notice,
and when.
Rapid mood lift
depression relief within hours to days, not weeks
Suicidal thoughts quieter
immediate reduction in suicidal or self-harm urges
Renewed energy
motivation and mental clarity return quickly
Physician oversight
every dose is supervised; safety is monitored
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Ketamine is a controlled substance (Schedule III in the US). It is prescribed only for treatment-resistant depression under careful physician oversight. Dissociation (feeling detached or hallucinating) is expected; your physician prepares you and controls the dose. Do not drive or operate machinery for 6-8 hours after dosing. Do not use ketamine if you have active or recent psychosis, uncontrolled high blood pressure, or hyperthyroidism. Tell your physician about any history of substance use, suicidal ideation, or psychosis. Ketamine carries abuse potential; use only as prescribed in a monitored setting. Stop and seek emergency care for severe dissociation, chest pain, very high blood pressure, or confusion lasting beyond expected time.
The research behind
ketamine.
Ketamine is an NMDA receptor antagonist with fast antidepressant effects in randomized trials of intravenous infusion. The trials are of IV ketamine and esketamine, not of the orally disintegrating tablet, which We found no trial for.
- Depression, 24 hours7.95 points
In a two-site randomized trial of 73 patients with treatment-resistant major depression, one intravenous ketamine infusion lowered MADRS depression scores by 7.95 points more than midazolam at 24 hours. Response was higher with ketamine.
Murrough et al., Am J Psychiatry 2013 - Compared with ECT55.4% vs 41.2%
In an open-label trial of 403 patients with nonpsychotic treatment-resistant depression, ketamine given as IV infusion twice weekly was not inferior to electroconvulsive therapy. Response was 55.4% on ketamine and 41.2% on ECT, a difference of 14.2 points. The trial was unblinded.
Anand et al., NEJM 2023 - Oral tabletsno trial found
We found no published trial of the orally disintegrating ketamine tablet for depression. Its effect is inferred from IV and other routes, and bioavailability differs.
Search of PubMed for ketamine orally disintegrating
What the studies found
- Faster antidepressant effect: one IV infusion lowered depression scores by 7.95 points more than midazolam at 24 hours in treatment-resistant depression (Murrough et al., Am J Psychiatry 2013).
- Response of 55.4% against 41.2% for electroconvulsive therapy in a non-inferiority trial of 403 patients with treatment-resistant depression (Anand et al., NEJM 2023).
- In treatment-resistant bipolar depression, serial IV ketamine lowered MADRS scores by 7.3 points more than midazolam at day 14 (Orsini et al., JAMA Psychiatry 2026).
Trial results are with IV ketamine given in a clinic under supervision, not with home-use tablets. Compounded ketamine tablets were not studied, and dissociative effects and blood-pressure rises are part of each dose.
What this does not say
- Ketamine's antidepressant effect is usually temporary without repeated dosing.
- Ketamine is a controlled substance and raises blood pressure during and after dosing.
- Trials excluded people with psychosis and many other conditions.
The research
behind it.
Ketamine produces rapid antidepressant effects in treatment-resistant depression in multiple randomized controlled trials. Dissociation is short-lived and dose-dependent; it is managed by physician dosing.
Long-term ketamine safety is emerging. The controlled setting and sublingual (not IV) dosing reduces risks. Abuse potential and cognitive effects with chronic dosing require careful monitoring and clear protocols.
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Ketamine ODT?
Dissolved under the tongue, once a day. The starting prescription is 1 tablet (50 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Ketamine ODT come in?
The pharmacy carries 2: 50 mg, 100 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Is it a controlled substance?
Yes. The law requires a live video visit with the physician before it can be prescribed.
Is ketamine safe for depression?
Ketamine has strong evidence for treatment-resistant depression when prescribed and monitored by an experienced physician. The rapid antidepressant effect can be life-saving in severe cases. Dissociation, abuse risk, and cognitive effects require close oversight. Ketamine is not a first-line treatment; it is reserved for people who have not responded to standard therapy.
How fast does ketamine work?
Many people feel relief within hours to a day. Some feel changes within minutes of the first dose. Unlike SSRIs, which take 4-6 weeks, ketamine acts rapidly. The effect may plateau or fade over days; your physician decides on repeat dosing.
What is dissociation?
Dissociation is a temporary detachment from your body or surroundings. You may feel floating, see mild visuals, or lose track of time for 30-90 minutes. It is expected, reversible, and managed by dose. Your physician prepares you and stays present during dosing.
Can I become addicted to ketamine?
Ketamine has abuse potential. Use only as prescribed, in a monitored setting, by your physician. Avoid driving or operating machinery for 6-8 hours after a dose. Report any urge to use ketamine outside of medical supervision immediately.
Ketamine educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
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References
- 1.Ketamine for treatment-resistant depression: a systematic review and meta-analysis. J Psychiatr Res, 2020
- 2.Rapid-acting antidepressants: implications for clinical practice and drug development. Nature Rev Neurosci, 2021
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.