Valrico has no Ascend dosing room, and neither does anywhere else in eastern Hillsborough. Ketamine is administered at one address only: 27724 Cashford Circle, Suite 102, Wesley Chapel, FL 33544. The medication given there is a compounded preparation that is not FDA-approved, which this page explains in full further down. The psychiatric evaluation that decides whether it is appropriate for you can be completed by Florida telehealth from 33594 or 33596. Call (813) 670-3005 or book a consultation.
What gets treated first, before ketamine is on the table
A persistent depression that has not responded to two medications is often a depression sitting on top of something nobody has screened for. The evaluation looks for that deliberately, because adding an interventional treatment over an unaddressed driver tends to produce a brief response and a fast return.
Untreated sleep apnea is the one found most often, and it is easy to miss because the daytime exhaustion, poor concentration and low mood it produces look exactly like depression. Anyone who snores heavily, wakes unrefreshed, or has been told they stop breathing at night gets referred for a sleep study before conclusions are drawn. Thyroid dysfunction is checked for the same reason. Alcohol is asked about directly, in units rather than in adjectives, because regular heavy use both maintains depression and changes what is safe to prescribe. Anemia, vitamin D and B12 deficiency, and chronic pain that nobody is managing all belong on the same list.
Two psychiatric findings change the plan rather than the workup. A history of elevated mood, reduced need for sleep or impulsive periods raises the question of bipolarity, which does not rule ketamine out but does change how it is used and what else needs to be in place. And an active substance use disorder is a reason to sequence treatment differently rather than a reason to be turned away without a plan. In each of these cases the honest recommendation is to fix the treatable thing first, and that recommendation is given even when it is not the one you came for.
Why someone else's account is part of the assessment
You are asked, at the evaluation, whether a partner, parent or close friend can add to the history. It is optional and plenty of patients decline, but it is worth understanding why it is offered rather than treating it as an intrusion.
Depression is one of the few conditions where the instrument being used to measure the symptom is also affected by it. Memory for good days is unreliable during a low period; people routinely under-report how long an episode has run, over-report how much a past medication was given a fair trial, and cannot see changes in themselves that are obvious to a household. The periods of unusually elevated mood or reduced need for sleep that matter most for safe prescribing are almost never volunteered by the person who had them, and are almost always noticed by someone living alongside them.
The same asymmetry runs in the other direction later in the series. Early response frequently shows up first to other people, as a returned sense of humor, a phone call that got answered, an easier evening, and only afterward to the patient. That is one of the reasons a series is not judged solely on how each week felt from the inside. If you would rather nobody else be involved, say so and the assessment proceeds on your account alone; nothing is discussed with anyone without your explicit permission, and the invitation is not repeated once declined.
A subcutaneous injection rather than an infusion
Ascend uses subcutaneous racemic ketamine, which is a single small injection into the tissue under the skin rather than a line maintained for the length of the session. That is a genuine difference from the free-standing infusion centers that make up most of the eastern Hillsborough market, and it changes the practical texture of a visit: less equipment, nothing to manage mid-session, and clinical attention on the patient rather than on the apparatus.
The structural difference matters more than the route, though. Here the dose is set by your response rather than by a fixed protocol, the same prescriber directs every session, a trained clinical team member monitors you throughout, and the plan is reassessed after each visit. Anna Stouffer, MS, PMHNP-BC, FNP-BC performs the evaluation and runs the dosing plan; she is dual board-certified in psychiatric-mental health and family practice, so the medical review determining candidacy happens in the same appointment. What things cost is discussed when we call you back rather than posted, because it depends on what the evaluation concludes.
A session takes about two hours: fifteen minutes of check-in and baseline vital signs, forty to sixty minutes of active dose time in a recliner in a private room, then twenty to thirty minutes of recovery observation. You will not be cleared to drive afterward, and the clinic confirms your ride before anything is given. The preparation administered is compounded and not FDA-approved, which is why the monitoring around it is not optional.
Regulatory status, in plain terms
Ketamine is not FDA-approved to treat depression, PTSD, anxiety, OCD, or chronic pain. The preparation used at Ascend is compounded, meaning it is assembled by a pharmacy instead of manufactured and reviewed as a finished product, and a compounded medication is not FDA-approved for any use. The agency has evaluated it for neither safety, nor effectiveness, nor manufacturing quality. That gets said again at your evaluation, in plain language, and it is named in the consent you sign before a first dose.
Two things follow from that status. Nothing is mailed to your home and no supply is issued for self-administration; the agency has published warnings about compounded ketamine shipped for unsupervised use, and every dose here is prepared for in-clinic use instead. And because ketamine is a Schedule III controlled substance with real potential for misuse and dependence, dosing frequency is set by the practice and revisited at every follow-up rather than continuing on an open schedule.
One limit on the evidence, worth stating rather than glossing: most published research used infusion administration rather than the subcutaneous route given here, so the findings transfer by reasonable inference. Ascend runs no nasal-spray and no at-home program, and the fact that the compounded preparation is not FDA-approved is exactly why the monitoring is fixed rather than discretionary.
Screening, and the effects to expect
Most effects are transient and settle before you leave: temporary dizziness or nausea, brief rises in heart rate and blood pressure, perceptual changes or mild euphoria during the active window, sometimes a headache or fatigue in the hours after. Dissociation during the dose is expected and temporary, which is why nobody is left alone in the room and why a medication that is not FDA-approved is never sent home with anyone.
Conditions reviewed during the consultation that can make ketamine inappropriate include severe or uncontrolled cardiovascular disease, uncontrolled hypertension, active psychosis or a documented primary psychotic disorder, active or untreated substance use disorders, and pregnancy. Bring a complete medication list including supplements. Benzodiazepines come up most often, with stimulants, several blood pressure medications and MAOIs also reviewed; mood stabilizers call for closer coordination rather than exclusion.
Treatment-resistant depression is the primary and most studied indication, generally meaning an inadequate response to two or more antidepressants at therapeutic doses. PTSD is considered after trauma-focused therapy, severe treatment-resistant anxiety on a smaller evidence base, and OCD, bipolar depression and select chronic pain conditions individually. None are assessed as certain to respond. If you are in immediate danger, call or text 988.
What the evidence establishes, and what it does not
A placebo-controlled pilot trial comparing routes of administration (Loo CK, et al., Acta Psychiatrica Scandinavica, 2016) reported response rates for the subcutaneous route broadly comparable to what the infusion literature had described, with a simpler delivery process and a shorter monitoring window. A two-site randomized controlled trial (Murrough JW, et al., American Journal of Psychiatry, 2013) reported 64% of participants meeting response criteria at 24 hours against 28% on an active midazolam control. A placebo-controlled add-on trial in bipolar depression (Diazgranados N, et al., Archives of General Psychiatry, 2010) found a rapid antidepressant response when ketamine was added to an existing mood stabilizer, a population that requires closer coordination with existing medication management.
None of that amounts to a promise, and none of it changes the regulatory picture: ketamine is not FDA-approved for these conditions. Group averages describe research cohorts, not individuals. Some patients respond, some partially, and a genuine minority notice nothing across a full induction series, which is addressed honestly at follow-up rather than answered with more sessions.
Valrico questions
Can any part of this happen closer to Valrico?
Not one operated by Ascend. There is no ketamine dosing suite in Valrico at Ascend, and none anywhere in eastern Hillsborough. Every session happens at the Wesley Chapel suite, 27724 Cashford Circle, Suite 102. Valrico patients are evaluated through the practice, usually by Florida telehealth, and are seen at Wesley Chapel for the dosing sessions themselves.
What does the first dosing session actually involve?
About two hours in total. Roughly fifteen minutes of check-in and baseline vital signs, then a single subcutaneous injection rather than a line placed for an infusion. The active window runs forty to sixty minutes in a private room with continuous monitoring, and you are not left alone during it. Recovery observation follows and ends when you are cleared rather than at a fixed time, so a first session occasionally runs longer than a later one while the response to your starting dose is being learned.
How is this different from the infusion clinics near Brandon?
Two differences. Ascend gives a subcutaneous injection rather than running a line for the session, and Ascend is a full psychiatric practice rather than a single-service clinic, so the same prescriber evaluates you, doses you, and follows up. The questions worth asking anywhere are who performs the evaluation, whether the same clinician is present each time, what is monitored, and what happens if the series does not work.
Do I need a referral from my doctor?
No referral is required, though bringing your treatment record helps enormously. What the evaluation needs is specifics: which medications, at what doses, for how long, and what happened. If a current prescriber is managing your medication, mention them so coordination can happen rather than being assumed.
Can the whole thing be done by telehealth?
No. Only the evaluation can. Dosing sessions are in person at Wesley Chapel, monitored from check-in to discharge, and there is no version of this where medication is sent to your home. That is a deliberate position rather than a limitation of the service.
What does maintenance look like after the induction series?
It depends entirely on your response rather than on a preset calendar. Some patients need no maintenance dosing at all; others do well with a single session every four to eight weeks. The interval is reviewed at each visit rather than left running indefinitely, which follows from the controlled-substance status rather than from a policy preference, and the ride requirement applies to a maintenance session exactly as it does to an induction one.
Adjacent service-area pages: Brandon and Riverview in south Hillsborough. The dosing-day walkthrough lives on the Wesley Chapel ketamine page; the service overview is at ketamine therapy at Ascend.
References
- 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.
- 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.
- 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.