In-Clinic vs. At-Home Ketamine: What Monitoring Changes
At-home ketamine programs and in-clinic treatment are two different models of care. What the FDA has said about compounded ketamine used without monitoring, and what that means for your choice.
The core difference is monitoring. At-home programs typically ship compounded ketamine, often as tablets or lozenges, to be taken without a clinician present. In a clinic, ketamine is given on site while staff watch for sedation, dissociation, and changes in blood pressure and heart rate. The FDA has warned that using compounded ketamine without that kind of monitoring may put patients at risk for serious adverse events.
Two different models of care
In the at-home model, an evaluation usually happens online, a compounding pharmacy supplies an oral or under-the-tongue form of ketamine, and you take it at home on a schedule. The FDA has noted growing interest in these sublingual and oral forms and their availability through telemedicine platforms and compounders.
In the in-clinic model, the medication never leaves the clinic. At Clear Ketamine Therapy, ketamine is given as a small injection under the skin at our Tampa clinic. You are monitored throughout, recover on site, and a responsible adult drives you home.
What the FDA said in October 2023
In an October 10, 2023 compounding risk alert, the FDA set out what patients and clinicians should know about compounded ketamine used for psychiatric conditions:
- Ketamine is not FDA-approved for the treatment of any psychiatric disorder.
- Compounded drugs, including compounded ketamine, are not FDA-approved, which means the FDA has not evaluated their safety, effectiveness, or quality before marketing.
- Using compounded ketamine without a health care provider monitoring for sedation, dissociation, and vital signs may put patients at risk for serious adverse events.
- Known safety concerns with ketamine include abuse and misuse, psychiatric events, increases in blood pressure, slowed breathing, and bladder and lower urinary tract symptoms.
- Compounded ketamine is not part of the monitoring program that applies to esketamine nasal spray, and the FDA noted that this may make it less safe.
Why monitoring matters during a session
Dissociation, which the FDA describes as a disconnection between a person's thoughts, feelings, and sense of space, time, and self, is an expected effect of ketamine. So are sleepiness and short-term changes in blood pressure and heart rate. In a monitored setting, a clinician can see these effects as they happen, check vital signs, and respond. At home, there is usually no one trained to do that.
What the in-clinic model does not change
Being in a clinic does not change what the medication is: ours is compounded too, so it is not FDA-approved either. What changes is the screening before treatment, the setting, and the person watching while the medication takes effect. We explain these distinctions before any treatment decision, and we never prescribe ketamine for use at home.
Questions to ask any ketamine provider
Whether you are looking at a clinic or an online program, these questions tell you a lot about how care is delivered:
- Is the medication compounded, and where does it come from?
- What screening happens before the first dose, and who reviews my medical history?
- Who is with me while the medication takes effect, and for how long?
- How are my blood pressure and heart rate checked, and what happens if they rise?
- Will I take any doses at home?
- Who do I contact if I feel unwell after a session?
In person or by telehealth
You can be seen both ways. Consultations, planning conversations, and follow-up visits happen in person at our Tampa clinic or by telehealth — whichever works better for you.
Ketamine itself is always administered in person, at the clinic, with a clinician monitoring you throughout. We do not prescribe ketamine for use at home.
Telehealth visits require you to be physically located in Florida at the time of the visit.
How telehealth works here
- Telehealth is available to patients who are physically located in Florida, and the clinicians providing that care hold active Florida licenses.
- Your location is confirmed at the start of every telehealth visit. If you are not in Florida, the visit does not go ahead.
- Ketamine is never prescribed for you to take at home. It is administered only at our clinic, in person, with a clinician monitoring you throughout — a telehealth visit does not change that.
- You are seen in person before any treatment session, because every session happens at the clinic.
- A telehealth visit never guarantees that treatment will be offered, any more than an in-person evaluation does.
- Telehealth is not for emergencies. If you are in crisis or having thoughts of self-harm, call or text 988, or call 911.
Common questions
The FDA has warned that using compounded ketamine without a health care provider monitoring for sedation, dissociation, and changes in blood pressure and heart rate may put patients at risk for serious adverse events. That warning is the reason our clinic gives ketamine only on site, with monitoring, and never prescribes it for use at home.
It depends on the provider. The ketamine used at our clinic is compounded, as at-home products typically are, and compounded ketamine is not FDA-approved. What differs here is the form it takes, the screening before treatment, and whether a clinician is with you while it takes effect. Ask any provider exactly what they use and how you will be monitored.
The conversations can. Your consultation, planning discussions, and check-ins between sessions can all take place over telehealth, provided you are physically in Florida at the time. The medication itself is only ever given at our Tampa clinic.
Expect to spend roughly an hour and a half to two hours at the clinic. That covers preparation, the treatment, and monitored recovery. You cannot drive afterward, so arrange for a responsible adult to take you home, and plan to avoid driving until the following day.
Sources & further reading
- FDA warns patients and health care providers about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders — U.S. Food and Drug Administration. Accessed 2026-10-29. The October 10, 2023 alert is listed on this FDA page.
Links point to external organizations. Clear Ketamine Therapy does not control their content.
Reviewed by Editorial team. Last reviewed 2026-10-29. Educational information only — not medical advice or a substitute for care from your own clinicians.
Keep reading
- Subcutaneous Ketamine TherapyWhat subcutaneous ketamine therapy involves, how it differs from IV and at-home products, and why medical supervision matters.
- Safety & Side EffectsThe full safety picture: common short-term side effects, who should not receive ketamine, the FDA's compounded-ketamine warning, and our monitoring practices.
- Am I a Candidate?Candidacy for ketamine therapy depends on your diagnosis, treatment history, health, and medications. Learn the factors clinicians weigh — and the next step.
- What to ExpectA plain-language walkthrough of the full treatment process at our Tampa clinic — the evaluation, the sessions themselves, and the follow-up — including the parts that vary from person to person.
Talk with our clinical team
A consultation is a conversation, not a commitment. Ask questions, share what you are comfortable sharing, and learn whether ketamine therapy may be worth considering for you.
Not for emergencies — call or text 988 or 911 if you are in crisis.