Nasal Ketamine: What It Is and What to Expect
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor provides Nasal Ketamine?
An otolaryngologist, often called an ENT doctor, treats conditions of the ear, nose, and throat. Nasal ketamine is usually given by a psychiatrist, pain specialist, anesthesiologist, or emergency doctor, depending on the reason for treatment. A primary care doctor may refer you to an ENT if regular treatments have not helped.
What it is
Nasal ketamine is a medicine sprayed into the nose. Ketamine affects signals in the brain and nerves, and nasal forms are used for conditions such as treatment-resistant depression, pain, or sedation. Doctors use it for conditions such as depression that has not improved with other treatments, for pain, or for sedation.
Why a doctor might recommend it
Some people have chronic rhinitis, which means long-term inflammation inside the nose. This can cause a stuffy or runny nose, sneezing, and postnasal drip. Many people manage these symptoms with store-bought sprays, allergy medicines, or prescription sprays. When those treatments do not work well enough, an ENT doctor may discuss other options, including nasal ketamine. Results differ from person to person, and your doctor will explain whether it makes sense for you.
How to prepare
- Ask your doctor which medicines to keep taking and which to pause before the visit.
- Bring a list of all medicines, vitamins, and supplements you take.
- Tell your doctor about any allergies and past reactions to numbing medicines or sedatives.
- Arrange a ride home if the medicine may make you drowsy.
What happens during it
The treatment is usually done in the doctor's office. The doctor may first clean the nose or apply a numbing medicine so you are more comfortable. The ketamine solution is then sprayed into the nasal passages. You may stay briefly afterward so the care team can watch how you feel.
Recovery
Most people go home the same day. Some feel drowsy, lightheaded, or a little foggy for a short time, so it is wise not to drive until you feel normal. Many people need more than one treatment session, depending on how your body responds.
Risks and side effects
Common side effects can include drowsiness, dizziness, nausea, or mild discomfort in the nose. Ketamine can affect blood pressure and heart rate, so your doctor will review your health history first. Serious problems are uncommon but can happen, which is why the treatment is done in a medical setting.
Who performs it
An ENT doctor usually performs nasal ketamine treatments. A primary care doctor can evaluate your symptoms first and refer you to an ENT if needed. If medicines and follow-up treatments are not enough, they will refer you to an ENT for options like nasal ketamine.
Common questions
Does nasal ketamine hurt?
Most people tolerate it well. Doctors often use a numbing medicine first, so you may feel pressure or a cold sensation rather than pain. Some stinging in the nose can happen.
How many nasal ketamine treatments will I need?
That depends on your condition and how your body responds. Some people need several sessions over time. Your ENT doctor will build a plan based on your results.
Is nasal ketamine the same as the illegal drug?
Ketamine has been used in medicine for decades, mainly as an anesthetic, a drug that prevents pain and awareness during procedures. The doses and setting used by doctors are very different from illegal use.
Can I drive myself home after nasal ketamine?
Probably not right away. Ketamine can make you drowsy or lightheaded for a while. Plan for someone to drive you until you feel completely normal.
Sources
- MedlinePlus - Esketamine Nasal Spray: MedlinePlus Drug Information
- MedlinePlus - Midazolam Nasal Spray: MedlinePlus Drug Information
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
