IV Ketamine Infusion Therapy in Los Angeles

When the Treatments You’ve Tried Haven’t Been Enough

There is a particular kind of exhaustion that comes from trying treatment after treatment and finding that nothing quite works — or that what worked for a while has stopped. If you’ve been through two, three, or more antidepressants without lasting relief, you may have been told that your depression is “treatment-resistant.” That label can feel like a door closing.

IV ketamine infusion therapy is, for many people, the door opening back up.

Julian Macias, PMHNP-BC, brings four-plus years of IV ketamine experience — including training at Ketamine Clinics Los Angeles under Dr. Steven Mandel, where he supervised up to ten infusions per day — to a boutique, patient-centered private practice in Los Angeles.

How IV Ketamine Therapy Works

Most antidepressants work on the serotonin system — the same pathway targeted by SSRIs and SNRIs. They take weeks to build up in the system and don’t work for roughly one-third of people with depression.

Ketamine works differently. Instead of targeting serotonin, ketamine acts on the glutamate system — the brain’s primary excitatory neurotransmitter network. At sub-anesthetic doses administered through an IV, ketamine rapidly stimulates the growth of new synaptic connections in the prefrontal cortex and other regions of the brain that are often underactive in depression and PTSD.

In plain terms: ketamine helps the brain grow new pathways in ways that haven’t been possible while stuck in the patterns of illness. Effects can begin within hours to days of treatment — not weeks. For people with treatment-resistant depression, PTSD, or significant anxiety disorders, that speed of response can feel nothing short of remarkable.

Who IV Ketamine Therapy Helps

IV ketamine infusion therapy is particularly well-suited for people who:

• Have tried two or more antidepressants without adequate relief (the clinical definition of treatment-resistant depression)
• Are living with PTSD that hasn’t responded to trauma-focused therapy or medication
• Are experiencing a severe depressive episode and need faster symptom relief than traditional medications can offer
• Have anxiety disorders that are significantly limiting daily functioning
• Have been diagnosed with bipolar disorder and are managing depressive phases
• Are looking for a non-daily-medication option that supports longer-term change

What a Session Looks Like: Before, During, and After

Before your infusion:Julian conducts a thorough psychiatric evaluation before any infusion series begins. This includes a review of your full psychiatric and medical history, current medications, and treatment goals. You’ll have time to ask questions and understand what to expect. On infusion day, you’ll be asked to fast for a few hours beforehand and to arrange transportation home. You will not drive yourself after a ketamine session.

During your infusion:IV ketamine infusions typically last 40–60 minutes. You’ll be in a comfortable, calm environment. The infusion delivers a carefully calibrated sub-anesthetic dose of ketamine through an IV, monitored continuously throughout. Many patients describe the experience as dreamlike or dissociative — a sense of detachment from ordinary thought patterns, sometimes accompanied by vivid imagery or a floating sensation. Julian and his team are present throughout to ensure your comfort and safety.

After your infusion:The dissociative effects typically resolve within 30–60 minutes after the infusion ends. You should expect to rest for a short period before leaving, and you’ll need a ride home. Most patients can return to normal activities the following day. Julian builds follow-up check-ins into the treatment protocol.

Why KCLA Training Matters

Julian trained at Ketamine Clinics Los Angeles — recognized as the #1 ketamine clinic in the country — under the direct mentorship of Dr. Steven Mandel. KCLA has administered over 35,000 treatments with an 83% reported success rate. Training in that environment, at that volume, means exposure to the full range of patient presentations, responses, and clinical nuances that a lower-volume setting simply cannot replicate.

Most PMHNPs offering ketamine therapy have observed a handful of infusions. Julian has supervised thousands. That difference shows — in how sessions are monitored, how dosing is approached, how patients are supported, and how to recognize and respond to anything that arises.

The Integration Connection

IV ketamine infusion therapy is powerful. But what happens in the weeks after treatment is just as important as the infusions themselves.

Ketamine creates a neuroplasticity window — a period of two to four weeks when the brain is more open to change than usual. Without intentional support during that window, old patterns reassert themselves and the benefits of treatment can fade.

Julian’s 12-Week Ketamine Integration Program is designed specifically to help patients use this window. Through structured journaling, AI-guided behavioral support, and regular check-in touchpoints, the program helps new patterns take root during the period when your brain is most capable of building them.

Understanding the Cost of Ketamine Therapy in LA

IV ketamine infusion therapy is not currently covered by most insurance plans, though some plans may offer partial reimbursement. In the Los Angeles area, IV ketamine infusions typically range from $400 to $800 per session at most clinics, and a standard initial series involves six infusions over two to three weeks.

Julian’s practice is transparent about pricing during the consultation process. He is committed to honest, clear communication about costs so that patients can make informed decisions about their care.