How is ketamine used in mental health treatment? 

There are three generally accepted uses of ketamine in psychiatry. 

Psychedelic ketamine-assisted psychotherapy (KAP) includes intramuscular (IM) or intravenous (IV) dosing experiences with ketamine and include brief therapy before and after dosing, and psychotherapeutic integration sessions in between dosing sessions. 

Psycholytic ketamine-assisted psychotherapy (KAP) includes lozenges (oral) or nasal spray (nasal) taken at the beginning of a dosing session to facilitate openness and deeper therapeutic work with a therapist present for the entire session. 

Psychiatric ketamine or Spravato as a medical intervention includes nasal spray of Spravato, an FDA-approved ketamine medication for depression. This treatment solely focuses on a decrease of depressive symptoms and does not typically include a therapeutic component.