Ascend has no dosing room in Clearwater, and none anywhere in Pinellas County. Every ketamine session happens at one suite: 27724 Cashford Circle, Suite 102, Wesley Chapel, FL 33544. For a Pinellas patient that makes this mostly a logistics decision, so this page is written as one. The psychiatric evaluation that determines whether ketamine is even appropriate is available by Florida telehealth, so nobody crosses the bay to be told no. The medication used here is compounded and not FDA-approved, which is covered in full further down. Call (813) 670-3005 or book a consultation.
Where ketamine sits among the things you have already tried
Ketamine is not a first step and the evaluation treats it that way. Before it is a defensible option, the record needs to show adequate trials of standard treatment, and adequate is a technical word rather than a sympathetic one. It means a therapeutic dose, not a starting dose someone never moved up from, held for six to eight weeks rather than abandoned at three because the early weeks were unpleasant. A great many people who describe themselves as having tried everything have in fact tried several medications briefly, at low doses, during periods when something else was also going wrong.
That distinction changes the recommendation. If two antidepressants were each pushed to a proper dose for a proper length of time and neither did enough, the treatment-resistant label fits and ketamine is reasonable to discuss. If a medication was stopped early, or never titrated, or taken through an untreated thyroid problem, heavy alcohol use, or a sleep disorder that nobody screened for, the sensible next move is usually to correct that first. Adding an interventional treatment on top of an unaddressed cause tends to produce a short response and a fast relapse.
None of this is a gatekeeping exercise. It is the difference between a plan built on your actual history and one built on a summary of it, and it is why the evaluation asks for dates and doses rather than a list of names. Anna Stouffer, MS, PMHNP-BC, FNP-BC makes that call and directs every session afterward.
The ride requirement, and the hours after a dose
You cannot drive yourself home. That is confirmed at check-in before anything is administered, and it is not waived because you feel alert at discharge. The requirement exists because the medication is a Schedule III controlled substance given in a monitored setting, not because of how far you have come, and it applies identically to every patient.
- What is expected. Tiredness, mild unsteadiness, a flat or slightly detached feeling, and occasionally a headache for several hours. Most patients describe the evening as low-energy rather than unpleasant. Sleep that night is often deeper than usual.
- What warrants a call. Vomiting that does not settle, chest pain or palpitations, a headache that worsens rather than fades, confusion that persists into the next morning, or any return of suicidal thinking. None of these are common; all of them are worth a phone call rather than a wait-and-see.
- What to have arranged in advance. No obligations that require you to drive yourself, operate machinery, or sign anything consequential for the remainder of the day. Someone reachable at home for the first evening of the series is sensible even if it proves unnecessary.
By the next morning most patients are back to their usual baseline and return to work without difficulty. Report anything that persists past that point at the following visit rather than absorbing it, because a lingering effect is one of the inputs used to adjust the next dose.
Bring your Pinellas medication history with you
Most Clearwater patients arrive already carrying a substantial record from prescribers on their own side of the bay. That record is the most useful thing you can bring. The evaluation turns on what has genuinely been tried: which antidepressants, at what dose, for how long, and what actually happened. A vague history produces a vague recommendation.
Bring a current medication list including anything over the counter. Benzodiazepines come up most often, because regular use may interact with how ketamine behaves and the timing is worth discussing rather than guessing at. Stimulants, several blood pressure medications and MAOIs are reviewed for the same reason. Lithium and other mood stabilizers are not a reason to skip an evaluation, but they do call for closer coordination with whoever prescribes them now.
Anna Stouffer, MS, PMHNP-BC, FNP-BC performs the evaluation and directs every session afterward. She holds dual board certification in psychiatric-mental health and family practice, so the medical review that decides candidacy happens inside the same appointment rather than as a separate referral. Fees are discussed when we call you back rather than posted, because what you need is not known until the evaluation concludes.
The regulatory status of what you would receive
Ketamine is not FDA-approved to treat depression, PTSD, anxiety, OCD, or chronic pain. What Ascend administers is a compounded preparation, assembled by a pharmacy rather than produced and reviewed as a finished commercial product, and a compounded preparation is not FDA-approved for any use at all. Nobody at the agency has evaluated this medication for safety, for effectiveness, or for manufacturing quality. That is stated here, stated again during your evaluation, and named explicitly in the consent you sign before a first dose.
Because it is not FDA-approved and because it is a Schedule III controlled substance, two things follow that Pinellas patients comparing options should weigh. Ascend does not mail this medication and does not issue a supply for you to take at home; the agency has warned publicly about compounded ketamine shipped for unsupervised self-administration, and declining to do that is a deliberate choice rather than an oversight. And dosing frequency is set and reassessed by the clinic at every follow-up rather than left running indefinitely, because misuse and dependence are real considerations with a Schedule III substance.
One more honest limitation. Most of the published research was conducted using infusion administration, not the subcutaneous route used here, so the evidence applies by reasonable inference rather than directly. We would rather say that plainly than let you assume the trials studied exactly what you would receive.
A subcutaneous injection, monitored in one room
A session runs about two hours end to end. Roughly fifteen minutes of check-in and baseline vital signs, then a small subcutaneous injection, then forty to sixty minutes of active dose time in a recliner in a private room with the option of an eye mask and headphones, then twenty to thirty minutes of recovery observation before discharge to your driver. Blood pressure, heart rate and your general response are tracked throughout rather than checked once at the start. The medication itself is compounded and not FDA-approved; the monitoring built around it is what makes this a clinical procedure rather than a delivery.
Most patients describe a dissociative or dreamlike interval: detachment from the body, mild changes in vision or in the sense of time, occasionally a floating sensation. That is expected rather than a complication, which is precisely why nobody is left alone in the room. Nausea, dizziness, short-lived rises in blood pressure or heart rate, and a headache or fatigue afterward are the common transient effects, and they generally settle before you leave.
The reasons we say no
Screening exists so that the patients for whom this is a poor idea find out before crossing the bay. Severe or uncontrolled cardiovascular disease, uncontrolled hypertension, active psychosis or a documented primary psychotic disorder, active or untreated substance use disorders, and pregnancy are all reviewed during the evaluation and any of them can make ketamine inappropriate.
There is also a timing answer that is not about your body at all. If first-line medication and therapy have not yet had a fair trial, if you are in acute crisis, or if you are looking for a single session rather than a structured series, the honest recommendation is usually to address that first. Ketamine is a later-line option assessed over weeks. If you are in immediate danger, call or text 988.
Treatment-resistant depression is the primary and most studied indication, generally meaning an inadequate response to two or more antidepressants at therapeutic doses. PTSD, severe treatment-resistant anxiety, OCD, bipolar depression and select chronic pain conditions are each assessed individually and on weaker evidence. None are treated as certain to respond.
What the evidence supports, and where it stops
A two-site randomized controlled trial (Murrough JW, et al., American Journal of Psychiatry, 2013) reported that 64% of participants met response criteria 24 hours after a single dose against 28% in an active midazolam control arm. A placebo-controlled pilot trial comparing routes of administration (Loo CK, et al., Acta Psychiatrica Scandinavica, 2016) found the subcutaneous route produced response rates broadly comparable to what the infusion literature had described, with simpler delivery and a shorter monitoring window. A placebo-controlled add-on trial in bipolar depression (Diazgranados N, et al., Archives of General Psychiatry, 2010) reported a rapid antidepressant response when ketamine was added to an existing mood stabilizer.
Those are group results from research conditions. They describe what happened to cohorts of participants, not what will happen to you, and ketamine is not FDA-approved on the strength of any of them. Some patients respond well, some partially, and a genuine minority get nothing meaningful from a full induction series. That last outcome is addressed directly at follow-up rather than answered with more appointments.
What Clearwater patients ask before they call
Can I be treated in Clearwater instead of at Wesley Chapel?
No. Ascend runs one ketamine site and it is in Wesley Chapel. There is no Ascend dosing location in Clearwater, in Largo, or anywhere else in Pinellas County, and we are not going to imply otherwise. Pinellas patients are evaluated through the practice, usually by Florida telehealth, and every dose is given at the Wesley Chapel suite.
How soon would I know whether it is working?
Sooner than with an antidepressant, which is one of the reasons the treatment is used at all, but sooner is not the same as immediately. Some patients notice a shift within hours of a first dose; others notice nothing until the third or fourth. What matters more than the first session is the trend across the series, which is why symptom scores are recorded each visit rather than relying on recall. If four sessions have produced no measurable movement, that is discussed as a result rather than treated as a reason to book more.
Do I keep taking my current antidepressant during the series?
Usually yes. Stopping an existing antidepressant at the same time a new treatment starts makes it impossible to attribute any change to either one, so the default is to leave the regimen alone through the induction series and revisit it afterward. The exceptions are reviewed individually at the evaluation: regular benzodiazepine use is the interaction raised most often, and MAOIs, several blood pressure medications and stimulants are checked against your current doses. Whoever prescribes those medications now stays involved rather than being replaced.
I already see a psychiatrist in Pinellas. Does that complicate things?
Not usually, and it often helps. Bring their medication record to the evaluation. Ketamine is assessed as part of a broader treatment plan rather than as a replacement for one, and an accurate history of what has already been tried is the single most useful thing you can arrive with.
Is the medication the same thing sold by at-home ketamine services?
The category overlaps but the supervision does not. Home services send a compounded oral or sublingual preparation for you to take with nobody present and no vital signs recorded. Ascend gives a monitored subcutaneous injection in a private room and does not mail medication. Neither one is an FDA-approved product, because a compounded preparation is not FDA-approved for any use, so the meaningful difference between them is the monitoring.
Will my insurance pay for this?
For the ketamine sessions themselves, most likely not. Coverage for racemic ketamine is inconsistent and usually out of network, and we do not bill insurance for the sessions. The psychiatric consultation may be partially covered by in-network psychiatric benefits depending on your plan. See our insurance and payment page for what can be checked in advance.
What happens if the series does not help?
You will be told that directly rather than sold more sessions. Because Ascend is a full psychiatric practice rather than a single-service clinic, care can move to a different medication strategy or a therapy referral without you restarting your history somewhere new.
The full walkthrough of a dosing day, including monitoring detail and provider background, lives on the Wesley Chapel ketamine page, since that is where treatment happens. The service overview is at ketamine therapy at Ascend.
References
- Murrough JW, Iosifescu DV, Chang LC, et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. American Journal of Psychiatry. 2013;170(10):1134-1142.
- Loo CK, Galvez V, O'Keefe E, et al. Placebo-controlled pilot trial testing dose titration and intravenous, intramuscular and subcutaneous routes for ketamine in depression. Acta Psychiatrica Scandinavica. 2016;134(1):48-56.
- Diazgranados N, Ibrahim L, Brutsche NE, et al. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Archives of General Psychiatry. 2010;67(8):793-802.