How the At-Home Ketamine Program Actually Works
A step-by-step look at the NutraBrain program — from the first qualifying quiz through medication delivery, your first session, and ongoing care — written by the physician who personally treats every patient.
Three Free Ways to Start — Before You Commit to Anything
Most telehealth ketamine programs push you straight into a paid consult. NutraBrain offers three no-cost entry points so you can find out whether ketamine therapy is right for you before any money changes hands.
Fastest
A short self-assessment that gives you an immediate read on whether you may be a candidate. No email required to see the result.
Most Common
A no-prescription, no-commitment conversation with the NutraBrain team. Ask anything. Decide later. Most patients start here.
Ready Now
Submit your medical and psychiatric history through our HIPAA-compliant form. Dr. Mahjoubi reviews before you book a paid consult.
The Program, Step by Step
Here is exactly what happens from the day you complete the intake form to the day your first prescription arrives at your door — and how the program runs from there.
1
Submit your HIPAA-compliant intake
Day 0 · 10–15 min
A structured medical and psychiatric history. We ask about your current symptoms, your treatment history, every medication you’ve tried, any cardiac or neurological conditions, and your goals for treatment. This is the same depth of intake a private psychiatric practice would do at a first visit.
2
Dr. Mahjoubi reviews your file personally
Within 24–48 hours
Not a triage team. Not a clinical coordinator. Dr. Mahjoubi himself reads your history before your first video visit. If at-home ketamine isn’t appropriate for you, he tells you before any visit is scheduled and refunds your deposit if one was taken.
3
Your video consultation with Dr. Mahjoubi
30–45 minutes
A real conversation with the physician who will be your prescriber. He reviews your history, answers every question, walks through what ketamine does mechanistically, designs your initial protocol — which delivery format, what starting dose, what schedule — and explains exactly what to expect from your first session.
$400 flat fee — includes your first 30-day supply of medication.
4
Your medication ships from a licensed U.S. compounding pharmacy
1–2 business days later
Compounded by one of three state-board-licensed pharmacies we work with: Novel Compounding (Sylmar, CA), Apothicare 360 (Lee County, FL), or The Chemist Shop (Long Island City, NY). Every batch carries a Certificate of Analysis. Shipped via tracked, signature-required courier in discreet packaging.
5
Your first dose, in a quiet space you already trust
First session at home
You’ll have step-by-step written guidance and a pre-session checklist. Most patients have a support person present for the first session. Have water and a light snack nearby, dim the lights, queue up calming music or a guided audio track. Mild dissociation during a session is the intended therapeutic effect — we’ll explain exactly what to expect on the previous page below.
6
Ongoing care under the membership
Ongoing · $69 / month
Includes unlimited refills, direct email access to Dr. Mahjoubi between visits, and protocol adjustments as your response evolves. No upsells, no auto-renewing packages, no surprise add-ons. Cancel anytime — no contract.
7
Annual video follow-up
Once per year · COMPLIMENTARY
A brief check-in with Dr. Mahjoubi after your first year — the minimum required by best-practice standards for a controlled substance prescription. Required by law, kept short by design.
Who Qualifies — and Who Doesn't
Honest candidacy criteria are how a serious medical program works. Some applicants are turned down. That conservatism is part of why the program is effective for the patients who are accepted.
Typically a Good Fit
- Treatment-resistant depression (two or more antidepressants tried)
- Major depressive disorder, persistent depressive disorder
- Stable, non-manic bipolar depression
- PTSD — combat, first-responder, or complex trauma
- Anxiety disorders that haven’t responded to standard treatment
- OCD with persistent intrusive thoughts
- Chronic pain — fibromyalgia, neuropathic pain, CRPS, post-surgical syndromes
- Patients who want faster relief than the SSRI ladder provides
Dr. Mahjoubi Will Not Prescribe For
- History of psychosis or schizophrenia
- Uncontrolled bipolar disorder with manic features
- Uncontrolled hypertension or unstable cardiac disease
- Active substance use disorder without stable recovery
- Current pregnancy or active planning of pregnancy
- Glaucoma with elevated intraocular pressure
- An at-home environment that isn’t safe for treatment
- Patients under 18
Five Delivery Formats — Matched to Your Brain, Not a Template
Most telehealth ketamine programs offer one format. NutraBrain offers five, and the right one depends on your symptoms, your tolerance, and how you want to engage with treatment. Dr. Mahjoubi picks the format with you during the initial consult.
| Format | Onset | Best For |
|---|---|---|
| Ketamine Nasal Spray | 5–10 minutes | Fastest non-IV delivery. Highest bioavailability of any at-home option. Good for patients who want a defined session window. |
| Sublingual Troche | 15–30 minutes | A slow-dissolving lozenge held under the tongue. Steadier, longer arc. Often preferred by patients new to the dissociative experience. |
| Rapidly Dissolving Tablet (RDT) | 5–15 minutes | Dissolves in 1–2 minutes. Onset between troche and nasal. A good middle-ground option. |
| Daily Microdose Lozenge | Cumulative, days to weeks | A protocol built around steady low-dose daily dosing instead of weekly sessions. Subtle, non-dissociative effect — designed for ongoing mood and anxiety support. |
| Ketamine + Oxytocin Nasal Spray Exclusive | 5–10 minutes | The only ketamine-oxytocin compounded formulation in U.S. telehealth. Designed for patients dealing with emotional numbness, attachment trauma, or relational disconnection. |
What a Session Actually Feels Like
Most patients want to know exactly what to expect before their first dose. Here is the honest physician’s answer, separated into what is expected and what is not.
Expected — This Is the Medicine Working
- Mild dissociation — feeling somewhat outside yourself. This is the therapeutic effect, not a side effect.
- Mild dizziness or floating sensation
- Transient nausea (usually preventable with pre-session guidance)
- Brief blurred vision
- Drowsiness afterward — most patients sleep deeply that night
- A general settling within roughly an hour of the session ending
Contact Dr. Mahjoubi Right Away If
- Severe vomiting that won’t stop
- Disorientation lasting more than two hours after the dose
- Severe anxiety or panic during the session
- Chest pain, palpitations, or shortness of breath
- A significant blood pressure spike on your home monitor
- Any reaction that feels meaningfully different from the previous session
When Patients Typically Feel Better
Traditional antidepressants take four to six weeks to begin working — if they work at all. Ketamine works on a different timeline. Individual response varies, but the patterns below match both the published literature and Dr. Mahjoubi’s practice of 3,900+ patients since 2014.
24 hrs
First session
Many patients report a noticeable shift in mood, calm, or clarity within the first 24 hours of their initial dose.
7 days
First week
Meaningful symptom improvement in mood, anxiety, sleep, or pain becomes apparent for the majority of responders.
14 days
Two weeks
Patterns of response stabilize. Dr. Mahjoubi adjusts dosing or format based on how you’ve responded.
30 days
First month
Your individualized maintenance protocol is established — sessions, microdose, or hybrid — tuned to your response.
Individual results vary. Published response rates in treatment-resistant depression run 60–70%, with the strongest evidence for IV ketamine in controlled settings. At-home intranasal and sublingual ketamine has a younger but rapidly growing evidence base. No responsible physician promises outcomes.
What It Costs — Every Number, Up Front
Pricing transparency is a deliberate choice. Most telehealth ketamine programs won’t tell you the cost upfront because they don’t have to. Here is exactly what NutraBrain costs in year one and every year after.
| What You Pay For | Cost | What's Included |
|---|---|---|
| Initial telehealth consult with Dr. Mahjoubi | $400 | 30–45 minute video visit. First 30-day medication supply included. |
| Ongoing membership | $69 / month | Refills, protocol adjustments, unlimited physician email access. Cancel anytime. |
| Refills | $0 | Included in the membership. No per-prescription fees. |
| Annual video follow-up (after year one) | Complimentary | One brief check-in per year with Dr. Mahjoubi. |
| Physician email access | Unlimited | Direct line to Dr. Mahjoubi between visits. |
| Total annual cost | ~$1,228 yr 1 ~$1,028 thereafter |
No hidden fees. No surprise add-ons. No auto-renewing packages. |
For context: cash-pay psychiatry plus brand-name antidepressants averages approximately $3,750 per year for treatment-resistant patients. In-clinic IV ketamine infusions typically run $400–$800 per session, with an initial course of six sessions costing $2,400–$4,800. HSA and FSA funds can be used for NutraBrain treatment in most cases. Most U.S. insurance plans do not cover off-label ketamine for psychiatric indications.
The Patient’s Guide to At-Home Ketamine Therapy
Free Download · PDF
A 5-page, physician-authored guide that goes deeper than this page can — the science, the full safety profile, what every session feels like, and exactly what to expect. Written by Dr. Mahjoubi for the patient who wants to understand the medicine before deciding.
Why the NutraBrain Program Runs Differently
Six structural choices that separate this program from how most telehealth ketamine companies operate.
One physician. Every patient. Every visit.
Dr. Mahjoubi personally reviews every file, runs every consult, and writes every prescription. Not a rotating roster of nurse practitioners.
Direct email access — no triage queue
Between visits, you email the physician directly. Not “the team.” Not a chatbot. Not a ticket that may or may not get to him.
Five formats, not one
Nasal spray, troche, RDT, daily microdose, and the only ketamine + oxytocin formulation in U.S. telehealth. The protocol is matched to your symptoms, not to a subscription box.
Up to 1,400 mg per week if clinically indicated
The highest dosing ceiling in U.S. telehealth. Most competitors cap far lower, which limits the protocol options when a patient under-responds
$69 / month, all-in, transparent
The lowest ongoing membership price in the category. Includes refills, protocol changes, and unlimited physician email. No upsells.
The credentials behind the prescriber
Board-certified anesthesiologist. President of the American Board of Ketamine Physicians. Sole author of The Art & Science of Ketamine Medicine — the only physician-authored ketamine treatment manual in print. Practicing ketamine medicine since 2014.
Frequently Asked Questions
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Most patients complete the full path — intake form, file review, video consult with Dr. Mahjoubi, and medication delivery — within seven to ten days. Several patients have gone from first inquiry to their first session inside of a week.
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No. Dr. Mahjoubi is your prescriber for every visit, every refill, and every email. That continuity is the central reason patients choose NutraBrain over high-volume telehealth platforms.
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Strongly recommended. A support person helps you feel grounded, can pour water, dim the lights, or simply be present in the room. After the first session most patients feel comfortable continuing on their own, but the choice is yours and Dr. Mahjoubi will discuss it during your consult.
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Dr. Mahjoubi will tell you directly. Some applicants are turned down — usually because of a contraindicated medical history, an unstable home environment, or because a different modality (such as in-clinic IV ketamine or Spravato) would be a better first step. Honest candidacy assessment is part of why the program is effective for the patients who are accepted.
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At sub-anesthetic doses — 5 to 15 times smaller than surgical anesthesia doses — ketamine has a wide pharmacological safety margin. The five things that make at-home ketamine safe are: a thorough medical and psychiatric evaluation before the first dose, compounding by a U.S.-licensed pharmacy, dosing within proven sub-anesthetic ranges, structured patient education on what to expect, and ongoing physician availability between sessions. NutraBrain does all five.
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Most U.S. insurance plans do not currently cover off-label ketamine for psychiatric indications. (They do typically cover Spravato, the FDA-approved esketamine nasal spray.) HSA and FSA funds can be used for NutraBrain treatment in most cases. Our team can help you understand your options.
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Yes. There is no contract and no auto-renewing package. You can cancel the $69/month membership at any time. If you cancel and later want to restart, you may need a brief catch-up video visit depending on how long has passed.
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IV ketamine in a clinic uses higher doses delivered intravenously over 40–60 minutes with a clinician present, typically packaged into six-session courses costing $2,400–$4,800. The published response rates are excellent. The cost, time, and travel are the friction. At-home ketamine uses sub-anesthetic doses delivered via nasal spray or sublingual formats in your own space, with substantially lower cost and no travel. Dr. Mahjoubi has run both models — he founded the Ketamine Healing Clinic of Los Angeles in 2014 — and helps each patient determine which is right for them.
Begin the NutraBrain Protocol
A board-certified anesthesiologist. The only ketamine + oxytocin formulation in U.S. telehealth. The lowest ongoing membership price in the category. And the same physician for every patient, every visit, every email.
Only 48 patient spots awarded per month nationwide.
Medical disclaimer: This page is for informational purposes only and does not constitute medical advice. Ketamine therapy is a prescription treatment and should only be undertaken under physician supervision. Individual outcomes vary. Ketamine use for mental health and chronic pain conditions outside of FDA-approved esketamine (Spravato) is considered off-label.
NutraBrain Clinic currently serves patients in Arizona, California (excluding Los Angeles and Orange Counties), Connecticut, Florida, Illinois, Massachusetts, New Jersey, New Mexico, New York, Texas, Utah, Virginia, and Wisconsin. If you are located in Los Angeles or Orange County, please visit www.phos.la.
Page reviewed and authored under the supervision of Dr. David Mahjoubi, MD. Last reviewed: June 2026.
