Most of the conversation about ketamine goes the way you would expect: the medications that did not help, what an infusion involves, what the evidence does and does not say. Then we get to the calendar.
Who drives you home after a ketamine infusion is a question to settle before you book. You cannot drive yourself, you cannot take a rideshare, and the person who brings you has to stay in the building the whole time you are here.
It is easy to treat that as a scheduling detail. A course that stalls after one infusion because nobody could get off work on a Thursday is what we are trying to prevent.
If today feels heavier than logistics and you are thinking about harming yourself, please do not wait for an appointment. Call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7, or go to your nearest emergency room. Our Fort Worth office is 817-659-7344 during business hours.
Who drives you home after a ketamine infusion? The rule, stated exactly
Our ketamine infusion therapy page puts it this way, and we mean it literally:
“You must have a responsible adult (age 18+) bring you, stay in the waiting area throughout your visit, and drive you home. You cannot be discharged alone, or to ride services such as Uber, Lyft, taxi, or to a driver who did not remain onsite.”
All four must be true on the same day:
| Requirement | What it means |
| A responsible adult, 18 or older | Not a minor, not you |
| Brings you | They are with you on the way in |
| Stays in the waiting area | The whole visit, not the parking lot |
| Drives you home | The same person who waited |
Every workaround fails the same test. At discharge, nobody in the room has been here, heard your instructions, and can get you home.
If you cannot name anyone, call 817-659-7344 and tell us before you book.
Why we require an escort, and where the rule comes from
Ketamine is FDA-approved as an anesthetic. Its use for depression is off-label and considered investigational by the FDA, which is how we describe it on our own service page.
That history is why the labeling talks about driving. The FDA-approved prescribing information for Ketalar (ketamine hydrochloride injection) tells clinicians to “advise patients not to drive an automobile, operate hazardous machinery, or engage in hazardous activities within 24 hours of receiving KETALAR.” That instruction was written for anesthetic dosing, and the doses used for depression are lower, but it is the FDA’s own counseling language and we hold to it.
The escort requirement comes from ordinary post-sedation practice. Federal Conditions for Coverage for Medicare-certified ambulatory surgical centers, at 42 CFR 416.52(c), require those facilities to “ensure all patients are discharged in the company of a responsible adult, except those patients exempted by the attending physician.” That regulation does not bind a self-pay psychiatry office like ours. It is the standard ambulatory care follows, and we follow it too.
A 2026 article in Patient Safety, the journal of the Pennsylvania Patient Safety Authority, explains why. Patients recovering from anesthesia, the authors write, “may experience numerous effects related to anesthesia, including cognitive and psychomotor dysfunction and poor recall”: slower thinking, slower movement, and a shaky memory of what they were just told. Rideshare services, they note, “offer no guarantee that a driver is capable of or willing to help a patient when they require assistance,” and drivers “are not required to demonstrate competence in the face of a medical or other emergency.” The authors group taxis with rideshares.
The problem with a rideshare is not the ride. It is that nobody in the car is responsible for you.
What actually happens on the day of an infusion
Our site describes it this way: a typical infusion lasts about 40 minutes, followed by a monitored recovery period. The infusion is the short part of your afternoon.
The common short-term effects we publish are dizziness, nausea, temporary increases in blood pressure, vivid dreams or perceptual changes, confusion, mood changes, or increased libido. They usually begin during or soon after the infusion and often improve within about 80 minutes, though they may last longer for some patients. Your visit may run shorter or longer, which is part of why your driver stays.
Those blood pressure changes are also part of why candidacy is screened before you book. The FDA-approved labeling for Ketalar says ketamine is contraindicated in patients for whom a significant elevation of blood pressure would constitute a serious hazard, and our own service page states that ketamine is contraindicated during pregnancy. Uncontrolled high blood pressure, significant heart disease, and pregnancy or possible pregnancy belong in that conversation before an infusion is scheduled.
The National Institute of Mental Health pooled safety data from five placebo-controlled trials at the NIH Clinical Center, covering 163 people with major depressive disorder or bipolar disorder plus 25 healthy controls. Each got a single infusion, at a dose well below what anesthesia uses. Most side effects, NIMH reported, “peaked within an hour of ketamine administration and were gone within two hours.” That was structured surveillance in an inpatient setting, and NIMH notes it did not address repeated infusions or long-term use.
Bipolar depression appears in that research as a study population. Ketamine has no FDA approval for depression of any kind; that use remains off-label and investigational. If bipolar disorder is in your history, or anyone has raised the possibility, tell us before you are treated. An accurate diagnosis changes what is safe to prescribe. Two people can describe the same flat, exhausted weeks and still need different medication, because in bipolar disorder an antidepressant working without a mood stabilizer carries a risk the other kind of depression does not: a shift into mania or hypomania. That is a reason for a different plan and closer monitoring, not a reason to adjust anything yourself. Never start, stop, or change a psychiatric medication on your own; that is a conversation with your prescriber.
How do you plan a whole series around the driver rule?
Ketamine for depression, again off-label and considered investigational by the FDA, is given as a series because the effect from a single infusion tends to fade. A 2015 review in the Annals of the New York Academy of Sciences reported that antidepressant effects after a single IV infusion “typically lasted 3-7 days,” and that among responders to repeated infusions “the average time to relapse after the last infusion was 18 days.” Our own framing: studies suggest a substantial proportion of treatment-resistant patients benefit, but not everyone responds, and improvements are often short-term, commonly around two weeks, with individual variation.
We do not publish a standard number of infusions; your clinician builds that plan with you. You are solving transportation for a whole course, easier now than after the first infusion.
A few things that help.
Build a bench, not a hero
Three or four people who can each say yes once hold up better than one who says yes to everything and quietly runs out of Thursdays. Tell our team if different people will be coming.
Make the ask concrete
“Can you drive me on the 14th and stay in the waiting room?” gets a real answer. “Could you ever help with appointments?” gets a warm maybe that evaporates. Ask when they are free first, then book.
Say what waiting looks like
They sit in the waiting area with a laptop or a book, and with your permission they hear your discharge instructions.
Look past family
If you moved to Fort Worth recently, or your relatives are two states away, the people who say yes are often a coworker, a neighbor, or the friend who keeps asking how to help.
If you cannot name anyone, say so before you book
Call 817-659-7344. The conversation may be about sequencing, or about another approach to treatment-refractory depression for now.
We are a self-pay practice with published rates. Since you are planning several appointments, total the current Price List for the plan you discuss.
Frequently asked questions
Can you Uber home after a ketamine infusion?
No. You cannot be discharged alone, to a ride service such as Uber, Lyft, or a taxi, or to a driver who did not remain onsite. A responsible adult 18 or older has to bring you, stay in the waiting area throughout your visit, and drive you home.
Can my driver drop me off and come back when I am done?
No. Your driver stays in the waiting area throughout your visit, so waiting in the parking lot or returning at an estimated discharge time does not meet the requirement. Plan for the whole appointment: the infusion is about 40 minutes, plus a monitored recovery period. With your permission, the person who waits also hears your discharge instructions.
When can I drive again after an infusion?
Not that day, and not for a full 24 hours. The FDA-approved labeling for Ketalar advises patients not to drive an automobile, operate hazardous machinery, or engage in hazardous activities within 24 hours of receiving it. That labeling was written for anesthetic doses, and we hold to the same window. Beyond it, follow the discharge instructions you are given at your visit.
What if I do not have anyone who can do this?
Call us at 817-659-7344 before you book and say so plainly. We cannot waive the requirement, and rideshare, taxi, and parking-lot arrangements are not options. Sometimes the answer is a different sequence of appointments, and sometimes a different approach to depression while you work the transportation out.
Is this the same as Spravato?
No. We provide intravenous ketamine, not Spravato. Spravato (esketamine) is a separate FDA-approved nasal spray available only through a restricted program. IV ketamine is FDA-approved as an anesthetic, and its use for depression is off-label and considered investigational by the FDA.
The bottom line
The transport rule is the first honest test of whether a ketamine series is workable for you right now, and the phone is a better place to find that out than the recovery room. A responsible adult 18 or older brings you, stays in the waiting area, and drives you home. Driving yourself, rideshare, taxis, and drop-off arrangements are not options. Ketamine leaves people temporarily impaired in judgment, coordination, and recall, and the FDA-approved anesthetic labeling for Ketalar advises against driving for 24 hours after a dose. Your discharge instructions govern your visit, and they will not clear you to drive that day. Plan the whole course around that, with more than one name on your list.
Talk with us
If you are in Fort Worth or the surrounding North Texas area and what you have read here sounds familiar, we would be glad to talk it through with you. The Institute for Advanced Psychiatry is an outpatient practice at 6800 Harris Parkway, Suite 100, treating adults 18 and older. You can request an appointment or call 817-659-7344.
If you are in crisis or thinking about harming yourself, please do not wait for an appointment. Call or text 988 to reach the Suicide & Crisis Lifeline, available 24/7, or go to your nearest emergency room.
Sources
- Institute for Advanced Psychiatry. “Ketamine Infusion Therapy.” Accessed 2026-09-02. https://www.psychiatryfortworth.com/services/ketamine-infusion-therapy/
- DailyMed / U.S. Food and Drug Administration. “KETALAR- ketamine hydrochloride injection (prescribing information).” Label version current as of access, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14e8f864-8b8a-4e7e-8439-e510d3107063
- National Institute of Mental Health. “Side Effects Mild, Brief With Single Antidepressant Dose of Intravenous Ketamine.” 2019. https://www.nimh.nih.gov/news/science-updates/2019/side-effects-mild-brief-with-single-antidepressant-dose-of-intravenous-ketamine
- U.S. Government Publishing Office. “Code of Federal Regulations, Title 42, Section 416.52 – Conditions for Coverage: Ambulatory Surgical Centers, paragraph (c) Standard: Discharge.” 2023 annual edition. https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol3/xml/CFR-2023-title42-vol3-sec416-52.xml
- Thomas A, Ferenschak J. “Should Patients Be Accompanied When Discharged From Ambulatory Surgery?” Patient Safety. 2026;8(2). https://patientsafetyj.com/article/161476-should-patients-be-accompanied-when-discharged-from-ambulatory-surgery
- DailyMed / U.S. Food and Drug Administration (Janssen Pharmaceuticals). “SPRAVATO- esketamine hydrochloride solution (nasal spray) prescribing information.” Label version current as of access, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d81a6a79-a74a-44b7-822c-0dfa3036eaed
- DeWilde KE, Levitch CF, Murrough JW, Mathew SJ, Iosifescu DV. “The promise of ketamine for treatment-resistant depression: current evidence and future directions.” Annals of the New York Academy of Sciences. 2015. https://pmc.ncbi.nlm.nih.gov/articles/PMC4447578/
- Institute for Advanced Psychiatry. “Price List.” Accessed 2026-09-02. https://www.psychiatryfortworth.com/price-list/
Medical disclaimer
This article is for general education and is not medical advice, a diagnosis, or a treatment recommendation for any individual. Reading it does not create a physician-patient relationship. Treatment decisions, including whether any medication or procedure is appropriate for you, should be made with a qualified clinician who knows your history. Do not start, stop, or change a psychiatric medication without talking to your prescriber. If you are experiencing a medical or mental health emergency, call 911 or 988.