Do I need a referral from my PCP for ketamine therapy?

A referral is not required at most ketamine clinics, including Music City Ketamine. However, we strongly encourage patients to keep their primary care physician in the loop. Coordinated care helps catch medication interactions, gives your PCP context for any blood pressure or mood changes they might see at future visits, and ensures everyone treating you is working from the same information.

What if my doctor says ketamine is just a club drug?

Acknowledge the historical concern, then redirect to the clinical evidence. Ketamine has been an FDA-approved anesthetic since 1970 and is on the World Health Organization's list of essential medicines. The FDA approved esketamine (Spravato) for treatment-resistant depression in 2019. The American Psychiatric Association published a 2017 consensus statement supporting IV ketamine for treatment-resistant depression in appropriate clinical settings. Bringing one peer-reviewed reference often shifts the tone of the conversation.

Should I stop my antidepressant before ketamine treatment?

No. Do not stop or change any medication without consulting your prescribing provider. Most patients continue their existing antidepressants throughout ketamine therapy, and the two approaches often work together. Your ketamine clinician will review your medication list with you, but adjustments to psychiatric prescriptions are made by the prescribing physician, not the infusion clinic.

Will Music City Ketamine send my PCP a treatment summary?

Yes, with your written consent. We can send your primary care doctor or psychiatrist a summary of the treatment plan, the protocol used, vitals during sessions, and any clinically relevant observations. Coordinated records help your PCP integrate ketamine into the bigger picture of your care, especially for blood pressure trends or medication review at follow-up visits.

What labs or tests will my PCP need to coordinate with ketamine therapy?

Most ketamine clinics ask for a baseline blood pressure reading and a recent medical history. Some request a basic metabolic panel or an EKG depending on your age and cardiovascular history. Your PCP can usually pull these from their records or order them at a routine visit. We will tell you exactly what we need before your first appointment so nothing slows you down.

What to Tell Your Primary Care Doctor About Ketamine Therapy

Why your PCP might be unfamiliar — and why that's not a red flag

If you mention ketamine therapy to your primary care doctor and get a blank look, a raised eyebrow, or a polite suggestion to talk to your psychiatrist instead, you are not getting bad care. You are running into a generational gap in medical training. Most practicing PCPs finished residency before 2019, the year the FDA approved esketamine (brand name Spravato) for treatment-resistant depression. The clinical literature on IV ketamine for psychiatric use exploded in the years that followed, and most family medicine and internal medicine programs still cover it lightly, if at all.

Ketamine itself has been FDA-approved as an anesthetic since 1970, and it is on the World Health Organization's list of essential medicines. Its use for depression, anxiety, PTSD, and chronic pain is off-label. That distinction matters in conversation. Off-label is not the same as experimental, unstudied, or fringe. It simply means the FDA has not formally reviewed the drug for that specific use, even when the underlying evidence is substantial. Most PCPs prescribe medications off-label every week without thinking about it.

Going in expecting your doctor to be somewhere on the curve from cautious to unfamiliar will save you frustration. The goal is not to convert them. The goal is to share information, get their medical input on safety, and make sure your care is coordinated.

The conversation framework: lead with what you have tried

The most productive way to open the conversation is not "I want to try ketamine." It is "Here is what we have tried, here is where I am, and here is what I am considering." That framing places the conversation inside your existing care rather than outside of it.

Walk in with a brief written summary covering:

Your diagnosis as your prescribing clinician has documented it (depression, treatment-resistant depression, PTSD, chronic pain, anxiety).
The medications you have tried, including dose, duration, and reason for stopping (no benefit, side effects, partial response).
Other treatments you have tried — therapy modalities, TMS, lifestyle interventions.
Where you are now — what is still not working and what specific symptoms are most disruptive.
What you are considering — IV ketamine therapy at a specific clinic, with a planned start date if you have one.

This document does two useful things. It signals that you are taking your care seriously, and it gives the doctor something concrete to react to. Most PCPs will engage more constructively with a patient who shows up organized than with one who asks an open-ended question about a treatment they barely know.

What literature to bring (and what not to)

You do not need a stack of journal articles. One or two well-chosen references usually do more than ten. The goal is to give your PCP a credible entry point, not to overwhelm them.

Useful references to print or email:

The original signal study. Berman and colleagues published the first clinical trial in Biological Psychiatry in 2000, demonstrating a rapid antidepressant effect of ketamine in depressed patients. This is the paper that opened the field.
The replication. Murrough and colleagues published a 2013 trial in the American Journal of Psychiatry showing that repeated IV ketamine infusions produced rapid antidepressant response in treatment-resistant depression.
The synthesis. McIntyre and colleagues published a 2021 review in the American Journal of Psychiatry that pulls together the evidence base and offers clinical considerations for IV ketamine in treatment-resistant depression. This is the single most useful reference to share, because it reads like a clinical primer rather than a single trial.
The professional consensus. The American Psychiatric Association published a 2017 consensus statement on ketamine for mood disorders. It is direct, sober, and written by clinicians for clinicians.
The regulatory anchor. The FDA's 2019 approval of esketamine (Spravato) for treatment-resistant depression. Even doctors skeptical of off-label IV ketamine generally accept that an FDA-approved nasal spray version exists for the same indication.

What not to bring: testimonial articles, podcast transcripts, or marketing material from clinics. These tend to make skeptical doctors more skeptical. Stick to peer-reviewed journals and regulatory sources.

Specific medical questions to ask your PCP

Coming in with specific questions changes the dynamic. Instead of asking your doctor to weigh in on ketamine in the abstract, you are asking them to do the medical work they are uniquely qualified to do.

"Are any of my current medications likely to interact with ketamine?" Lamotrigine, benzodiazepines, and certain blood pressure medications are worth specifically reviewing. Your PCP has your full medication list and can flag concerns.
"Is my blood pressure stable enough?" Ketamine causes a transient rise in blood pressure during infusion. Patients with poorly controlled hypertension or recent cardiac events may need optimization first.
"Do you want to see baseline labs or an EKG before I start?" Many clinics ask for these. Your PCP can usually pull them from recent visits or order them.
"Will you be willing to receive a treatment summary from the clinic?" This is the coordination question. A yes opens the door to integrated care.
"What symptoms or changes should I report back to you while I am in treatment?" This invites them into the loop on follow-up.

Medications your PCP should know you are on

Ketamine therapy is generally compatible with most psychiatric and chronic disease medications, but a small number of interactions deserve a careful look. This is not a list of medications you should stop. Never stop or change a prescription without consulting the provider who prescribed it. It is a list of medications worth flagging for your PCP and your ketamine clinician.

Lamotrigine and other anticonvulsants — some evidence suggests these may blunt ketamine's psychiatric effects. Your prescriber may have an opinion on timing.
Benzodiazepines — chronic high-dose use may reduce ketamine's antidepressant response. This is a discussion point, not a directive to stop.
Stimulants — usually compatible, but worth disclosing.
Blood pressure medications — relevant for monitoring during infusion.
MAOIs — less common today, but the interaction profile warrants careful review.
Opioids — if you take opioids for chronic pain, your ketamine clinician needs to know. Many chronic pain patients use ketamine alongside reduced opioid regimens, which is a conversation worth having across providers.

Coordinating care: bloodwork, BP, and follow-up

Practical coordination usually comes down to three pieces: baseline data, monitoring during treatment, and follow-up afterward. Your PCP can make all three easier.

Most ketamine clinics ask for a recent blood pressure reading and a basic medical history. Some request a basic metabolic panel or, depending on age and cardiovascular history, an EKG. Your PCP can usually provide these from their records or order them at a routine visit. We coordinate directly with referring physicians when patients want us to, and we are clear up front about what records would be helpful.

During the treatment series, your PCP may notice changes you do not. Mood, sleep, appetite, blood pressure trends — these are often documented at routine visits. A doctor who knows you are doing ketamine therapy can interpret those changes in context. A doctor who does not know is working with incomplete information.

For more on how the actual sessions work and what the protocol looks like, our guides on how ketamine works and the safety profile of IV ketamine are good things to share if your PCP wants more detail. The how it works overview on our main site is a quick read for clinicians who want the clinic-side view.

What to do if your PCP pushes back

Sometimes a doctor pushes back not because they disagree with the evidence, but because they have not seen it. Sometimes they push back because they have genuine concerns about a specific patient profile. Both are legitimate, and both deserve a real conversation.

If the pushback is about the drug itself — that ketamine is "just a club drug" or "experimental" — acknowledge the historical concern and redirect to the regulatory and clinical record. The FDA approval of esketamine, the APA consensus statement, and the body of peer-reviewed trials are the cleanest counterweights. Your goal is not to win a debate. It is to share a more complete picture.

If the pushback is about your specific clinical situation — uncontrolled blood pressure, a substance use history, an active manic episode — take the concern seriously. These are exactly the medical questions a primary care doctor is qualified to raise, and they may save you from a treatment that would not be safe at this moment.

If the conversation does not get anywhere, you still have options. Most ketamine clinics, including ours, do not require a PCP referral. You can proceed with treatment and offer your PCP a treatment summary afterward. Many physicians who were skeptical at the start come around once they see a patient improving. We have seen that pattern many times. For more on the broader cultural shift, the post on FDA and ketamine walks through the regulatory history. The piece on common ketamine myths covers the most frequent misconceptions.

How we communicate with referring physicians at Music City Ketamine

With your written consent, we send your primary care doctor or psychiatrist a summary that typically includes the protocol used, the dose range, vitals during sessions, your reported response, and any clinically relevant observations. Marla Peterson, CRNA, oversees every infusion and provides anesthesia-level monitoring throughout each session, and the records reflect that clinical detail.

If your PCP has questions, they are welcome to call us directly. Some patients prefer to be the conduit; some prefer that we coordinate physician to physician. Either works. Cost is also part of the practical picture: insurance generally does not cover IV ketamine for psychiatric or pain indications because it is off-label, and our sessions are $475 each. We are transparent about that from the start so you and your PCP can have an honest conversation about whether the time and money make sense for your situation. If you have questions we have not answered here, our FAQ page covers the most common ones, and the comparison piece on ketamine versus Spravato is a useful reference if your PCP asks why you are considering IV ketamine over the FDA-approved nasal spray.

The short version: bring data, bring specifics, ask real medical questions, and treat your PCP as a partner. Most of the time, that is exactly what they want to be.