IV ketamine, IM ketamine and Spravato® (esketamine) at our clinic at 80 Fifth Avenue, Union Square, for adults whose depression hasn't lifted with antidepressants. Every dose is supervised by board-certified psychiatrists. Spravato is FDA-approved for treatment-resistant depression; IV and IM ketamine are used off-label, and we explain what that means for you.
Or call (646) 817-2835 — speak with our team now
Medically reviewed by Yuli Fradkin, MD, board-certified psychiatrist · Last reviewed October 2026
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FDA-Approved Spravato
IV & IM ketamine used off-label
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Aetna, BCBS, Cigna, United
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Psychiatrists, 25+ years
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Dr Fradkin helped me with treatment-resistant depression using TMS.
Valery Dinner Verified Google ReviewI had a great experience at the Village TMS Center for Autism and Depression. The staff is very kind, professional, and truly cares about their patients. They take the time to listen and explain the treatment process clearly.
kibriyo komilova Verified Google ReviewMy son just finished TMS therapy with Village Group Medical. I am pleased to mention pleasant and welcoming atmosphere of this office. It helped my son relax and agree to undergo the therapy.
Yelena Haskin Verified Google ReviewAs an R.N. for decades I’ve had myriad experiences with institutions and providers. It takes a lot to impress me and that’s what Dr Fradkin and his affable staff have done! My treatments have been attended to with integrity, friendliness and skill. They provided scheduling flexibility, cost transparency, and a comprehensive orientation to my TMS treatments with a smile. Thus I have no reservations advocating Village TMS and award Dr Fradkin and his staff an A+.
Dennis Moriarty Verified Google ReviewI've been using Village Medical Group services for quite some time and can recommend it to everyone. Very easy easy and transparent communications, warm and welcoming office with people who care. George is very knowledgeable, helpful and I really appreciate his help all the time. Dr. Fradkin is amazing specialist that carefully and precisely chose the treatment that helped. I feel safe and comfortable every time I visit the office.
Nikita Khvastunov Verified Google ReviewVery professional and caring team. I enjoyed learning more about this solution and was pleased with the provided service!
Raul Ifraimov Verified Google ReviewTMS session with George went great. Even though I just started and it’s a new experience for me, a cautious supervision and guidance of the specialist helps to get through. I had all my questions being answered before the procedure. Will come again!
Ekaterina Kokovikhina Verified Google ReviewJust had my first TMS session. Feeling great!
Sofia Dro Verified Google ReviewINSIGHTS
Ketamine therapy is the medically supervised use of low-dose ketamine to treat depression that hasn't responded to standard antidepressants. Ketamine has been used as an anesthetic for decades. At much lower doses, researchers found it can ease depressive symptoms within hours to days for some people, rather than the weeks most antidepressants take.
It works differently from SSRIs. Ketamine blocks NMDA receptors in the brain's glutamate system, which is thought to set off a short burst of new connections between nerve cells. Researchers are still studying the details, but this helps explain why ketamine can help some people who have not responded to other medications.
One fact matters for both cost and expectations: ketamine itself is FDA-approved only as an anesthetic. Using IV or IM ketamine for depression is off-label. That is legal and common in psychiatry, but it means most insurers won't pay for it. Spravato, a nasal spray made from esketamine, is the FDA-approved option for treatment-resistant depression. We offer all three so your psychiatrist can recommend the one that fits you.
In a small randomized trial, a single ketamine infusion improved treatment-resistant depression within 24 hours for many participants (Zarate et al., Archives of General Psychiatry, 2006). For most, the effect of one dose faded within about a week, which is why ketamine is given as a series.
YOUR OPTIONS
We offer all three under one roof, so your psychiatrist can match the format to your symptoms, health history and insurance.
IV INFUSION
A slow intravenous drip over about 40 to 60 minutes, with heart rate and blood pressure monitored throughout. IV has the longest research record for depression and is often where we start for severe or treatment-resistant depression. Off-label; usually self-pay.
Nasal Spray
An FDA-approved esketamine nasal spray for treatment-resistant depression. You use it yourself under our supervision, then stay with us for at least two hours. Because it is FDA-approved, insurance often covers it. More about Spravato.
IM INJECTION
An injection into a muscle, with a shorter dosing period than IV and a lower cost per session. It is often used in ketamine-assisted psychotherapy. Off-label; usually self-pay.
FDA-APPROVED OPTION
Spravato® (esketamine) is a nasal spray made from one form of the ketamine molecule. The FDA approved it in 2019 for treatment-resistant depression in adults, taken with an oral antidepressant, and in 2020 for depressive symptoms in adults with major depression and acute suicidal thoughts or behavior. Since January 2025 it can also be used on its own for treatment-resistant depression (Spravato prescribing information).
Spravato is given only in clinics certified under the Spravato REMS program. After each dose you stay with us for at least two hours while we check your blood pressure and how you feel. You must not drive or operate machinery until the next day, after a restful sleep, so plan a ride home.
The usual schedule is twice a week for weeks 1 to 4, once a week for weeks 5 to 8, then weekly or every two weeks. Because it is FDA-approved, Spravato is covered by insurance more often than IV or IM ketamine. Your psychiatrist will confirm whether it suits you.
CLEAR COMPARISON
A side-by-side look to help you and your psychiatrist choose.
| Treatment | How it's given | Typical session length | FDA status | Insurance and cost | Best suited for |
|---|---|---|---|---|---|
|
IV Infusion |
Slow intravenous drip in the clinic |
About 40-60 min, plus recovery time |
Off-label for depression (approved only as an anesthetic) |
Usually self-pay; typically $400-$800 per session |
Severe or treatment-resistant depression |
|
IM Injection |
Injection into a muscle in the clinic |
Shorter dosing than IV, plus monitoring |
Off-label for depression |
Usually self-pay; lower cost per session than IV |
Patients who prefer no IV, and ketamine-assisted psychotherapy |
|
Spravato® Nasal Spray |
Self-administered nasal spray under supervision |
Dose plus at least 2 hours of monitoring |
FDA-approved for treatment-resistant depression |
Often covered with prior authorization |
Adults with treatment-resistant depression |
IV and IM ketamine are off-label and usually self-pay. Spravato is FDA-approved and more often covered. We verify your coverage for free. For a deeper comparison, read Spravato vs IV ketamine.
COST & INSURANCE
IV ketamine at Village TMS typically costs $400 to $800 per session, depending on your protocol. IV and IM ketamine are off-label for depression, so they are usually self-pay. Some patients recover part of the cost through out-of-network benefits.
IM ketamine costs less per session than IV. Spravato is different: because it is FDA-approved, it is often covered when your plan's criteria are met, usually with prior authorization, and your share depends on your deductible and copay.
We verify your benefits for free before your first session and walk you through the expected cost. For details, see our ketamine therapy cost guide and is ketamine covered by insurance?.
WHO IT'S FOR
Depression that hasn't improved after at least two antidepressants at an adequate dose and length of time. This is where the evidence for ketamine and Spravato is strongest. See treatment-resistant depression.
Spravato is FDA-approved for adults with major depression and acute suicidal thoughts or behavior, alongside standard care. If you are in crisis right now, call or text 988 or go to the nearest emergency room.
Psychiatrists also use ketamine off-label for OCD, PTSD, anxiety and bipolar depression. The evidence there is earlier and more mixed, and we go through it honestly with you first.
Ketamine is usually not advised with uncontrolled high blood pressure, certain heart or blood-vessel conditions, a history of psychosis, active substance misuse or pregnancy. Read who is not a good candidate.
HOW TREATMENT WORKS
STEP 1
A psychiatrist reviews your history, medications and past treatments, and we verify your insurance at no cost. We never give a first dose on the same day as the consultation.
STEP 2
Your psychiatrist recommends IV, IM or Spravato based on your diagnosis, health, goals and coverage, and explains why.
STEP 3
Every session takes place in our clinic, in a private room, with your vital signs tracked and a clinician present throughout.
STEP 4
We review your progress after each session and adjust the plan. If you want therapy alongside dosing, ask about our ketamine-assisted psychotherapy program.
THE PATIENT JOURNEY
Your first visit is a consultation, not a treatment. Come to 80 Fifth Avenue and take the elevator to Suite 1405. A psychiatrist takes a full medical and psychiatric history, reviews your medications and explains your options. The gap before your first session gives you time to think and ask questions.
On treatment days, arrive about 15 minutes early. An IV infusion runs about 40 to 60 minutes, IM dosing is shorter, and Spravato includes at least two hours of monitoring. Many people feel a floating or dreamlike sense of detachment that fades as the session ends. A clinician is with you the whole time.
You rest in our recovery area until you feel steady. Someone needs to take you home: no driving for the rest of the day after IV or IM ketamine, and with Spravato not until the next day after a restful sleep. Avoid big decisions that day.
IV and IM ketamine usually start with an initial series over a few weeks, then less frequent sessions if they are helping. Spravato follows a set schedule: twice weekly for weeks 1 to 4, weekly for weeks 5 to 8, then weekly or every two weeks. Your psychiatrist tracks your symptoms and adjusts the plan.
HONEST ANSWERS
Ketamine has been used in medicine for decades, and at the low doses used for depression most side effects are short-lived. The most common are dissociation (feeling detached or dreamlike), dizziness, nausea, sleepiness and a rise in blood pressure. These usually ease within a couple of hours of a session.
Ketamine also has real risks that we take seriously. It can be misused, so we give it only in the clinic and never as a take-home prescription. Frequent heavy use has been linked to bladder problems. We screen for blood pressure, heart conditions, psychosis and substance use before recommending it. Read more about ketamine side effects.
A board-certified psychiatrist oversees every session. Screening decides whether ketamine is appropriate for you.
Board-certified psychiatrists with decades of experience treating depression, OCD and anxiety.
Board-Certified Psychiatrist · 25+
Years Experience
I founded Village TMS because so many of my patients had been failed by
standard treatment paths. My approach is unhurried, evidence-driven, and centred on what each person actually needs to feel like themselves again.
Board-Certified Psychiatrist · 15+ Years Experience
I came to TMS after watching patients
cycle through medications that didn't fit them. My focus is precision, matching the right protocol to the right person, and adjusting as we go.
Psychotherapist & Coach ·
Couples Therapy
I help adults and couples build self-awareness and deepen relationships. My work is grounded in Gestalt therapy and informed by EMDR, mindfulness, and transpersonal psychology. I combine deep emotional exploration with practical tools, working in a warm, collaborative space where clients feel genuinely seen and supported.
Everything you need to know before your free consultation.
Ketamine therapy is the medically supervised use of low-dose ketamine to treat depression, most often depression that hasn’t improved with at least two antidepressants. At Village TMS it is given as an IV infusion, an IM injection or Spravato nasal spray, always in our Manhattan clinic under a board-certified psychiatrist.
Ketamine is FDA-approved only as an anesthetic. IV and IM ketamine for depression are used off-label, which is legal and common in psychiatry. Spravato (esketamine) is the FDA-approved option for treatment-resistant depression and for major depression with acute suicidal thoughts or behavior.
At Village TMS, IV ketamine typically costs $400 to $800 per session. IM ketamine costs less per session. Spravato is often covered by insurance, so your cost depends on your plan. See our ketamine therapy cost guide.
Insurance often covers Spravato when your plan’s criteria are met, usually with prior authorization. IV and IM ketamine are rarely covered because they are off-label, though out-of-network benefits sometimes reimburse part of the cost. We check your coverage for free. More on whether ketamine is covered by insurance.
In clinical studies, some people with treatment-resistant depression improved within hours to a day of an infusion. Others need several sessions, and some don’t respond. We track your symptoms at every visit so we can tell whether it is working.
The most common are dissociation, dizziness, nausea, sleepiness and a rise in blood pressure. They usually ease within a couple of hours. We monitor you throughout, and you cannot drive afterward.
Ketamine can be misused, and repeated heavy use carries risks including dependence and bladder damage. That is why we give it only in the clinic at measured doses, screen for substance use first and never prescribe it to take home.
80 Fifth Avenue, Suite 1405, New York, NY 10011, on the corner of Fifth Avenue and 14th Street. It sits between Union Square and Greenwich Village, at the southern edge of the Flatiron district. We treat patients at this one location.
From Williamsburg, the L runs direct to Union Square in about 15 minutes. From Brooklyn Heights and Park Slope, the 4, 5, N and R connect to Union Square. From Astoria and Long Island City, take the N, R or W. From Hoboken or Jersey City, the PATH to 14th Street takes about 15 minutes. See getting to Village TMS.
Street parking near 80 Fifth Avenue is limited, and there are several commercial garages within two blocks. Since you can’t drive yourself home after a session, most patients use transit or a rideshare, or come with someone who can drive.
No. We give ketamine only in person at our Manhattan clinic, with screening beforehand and monitoring throughout. We’re happy to talk through other options at your consultation.
Book a free consultation by calling (646) 817-2835 or through our contact page. We’ll review your history, explain whether ketamine, Spravato or another option such as TMS therapy fits, and verify your insurance.
INSIGHTS
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EXPLORE OUR SERVICES
VISIT US
Village TMS is at 80 Fifth Avenue, Suite 1405, on the corner of Fifth Avenue and 14th Street, between Union Square and Greenwich Village at the southern edge of the Flatiron district. It is a quiet professional building, not a hospital lobby. The L, N, Q, R, W, 4, 5 and 6 trains stop at 14th St–Union Square, and the F and M stop a short walk away at 14th Street. See getting to Village TMS for step-by-step directions.
Union Square · Flatiron · Chelsea · Greenwich Village · West Village · East Village · SoHo · Tribeca · Midtown. Usually 5 to 20 minutes away.
Williamsburg · Brooklyn Heights · Park Slope · Long Island City · Astoria · Forest Hills. The L runs direct from Williamsburg to Union Square; the N, R and W come in from Astoria and Long Island City.
Hoboken · Jersey City · Weehawken · Edgewater · Fort Lee. The PATH to 14th Street takes about 15 minutes from Hoboken or Jersey City.
