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Better U Programs

Through its affiliated practices, Better U supports clinicians who provide a range of holistic mental‑health and wellness services, which may include:
At-Home Ketamine Therapy
Psychiatric evaluation and medication management
Psychotherapy and integration‑focused coaching
Weight‑management and metabolic‑health programs
Sexual‑health and longevity‑focused services
Availability, specific modalities, and medications vary by state and by clinician, and each treatment has its own risks, benefits, and alternatives that must be discussed in a separate informed‑consent process.

While psychedelic therapy may be an appropriate option, it is not without risk. Better U’s medical advisory team and Better U Clinical Group review emerging literature and professional guidelines and consider evolving, evidence‑based practices when designing protocols to support affordable access to psychiatric care. Interest in medically supervised, evidence‑informed psychedelic care has grown in recent years, but many uses remain “off‑label,” meaning they are not specifically approved by the FDA for psychiatric indications.
Although these healing modalities are ancient in many ways, the psychiatric application is cutting edge. In light of the diverse protocols in the community, here is  an overview of how Better U ensures works at every step of our program.

Healing is Different for Everyone

At‑home ketamine therapy is not appropriate for all patients. Virtually guided protocols require reliable social support and adequate physical and mental health. Initial screening begins with an online assessment to identify risk factors and assess whether this treatment is medically appropriate, followed by review from care coordination and a comprehensive evaluation by a licensed clinician to determine medical and psychiatric suitability. Some clinicians affiliated with Better U may incorporate ketamine or other psychedelic‑adjacent modalities as part of a broader treatment plan when, in their professional judgment, it is clinically indicated and consistent with applicable standards of care. These treatments involve inherent risks and may not be suitable for every patient, and no specific outcomes, symptom relief, functional improvement, or reduction in other medications are promised or guaranteed. At‑home ketamine therapy, including virtually guided protocols, will not be prescribed where a clinician determines that the potential risks outweigh the potential benefits, in accordance with clinical and regulatory requirements. Better U–affiliated clinicians generally do not prescribe at‑home ketamine for people who fall into categories such as:
  • Clients younger than 18
  • Those pregnant or nursing
  • Those struggling with acute substance dependence
  • Psychotic disorder or those with history of unaddressed psychotic symptoms
  • Bipolar disorder with severe mania
  • Unstable medical conditions including but not limited to: hypertension, chronic cardiac disease, aneurysmal vascular disease, respiratory illnesses, seizure disorder, or thyroid disease
  • History of intracerebral hemorrhage (brain bleeds), or hypersensity to esketamine or ketamine
  • Moderate to severe liver disease
  • History of elevated intraocular or intracranial pressure
  • Other serious medical illness
  • Those who do not meet the criteria for a psychiatric diagnosis under the current standard of care
These criteria are applied in conjunction with state and federal requirements and with reference to evolving evidence‑based practices on ketamine use in psychiatric settings, including guidelines from professional associations such as the American Psychiatric Association and other relevant specialty organizations.

Care Process and Touchpoints

Better U’s care coordination team focuses on patient education, safety, and clear communication throughout the treatment journey. After the online assessment, a care coordinator contacts the patient to confirm medical history and review basic safety information. Before any prescription is written, patients meet with a licensed clinician for 30-55 minutes (depending on provider/patient) psychiatric evaluation. Clinicians follow structured protocols to develop individualized treatment plans when they determine ketamine is appropriate, including dose selection, monitoring requirements, and follow‑up schedules. Patients receive an explanation of the proposed treatment, potential risks and benefits, and alternatives, and are encouraged to ask questions so they can make an informed decision.

Patient Safety & Eligibility

Better U provides a platform for patients to connect with licensed clinicians who may consider ketamine therapy for conditions such as treatment‑resistant depression, PTSD, or certain anxiety disorders when appropriate. Better U can also help patients connect with coaches or licensed therapists for additional support, though these services are not a substitute for emergency or inpatient care. At‑home ketamine protocols are generally not recommended for individuals with complex or unstable conditions, such as schizophrenia, current psychosis, active substance use disorders, or certain serious medical issues; some of these patients may be better suited to in‑person care or may not be appropriate for ketamine at all. In some cases, clinicians may ask for medical clearance or additional records from a patient’s primary‑care or specialty clinician before proceeding. If, after evaluation, a clinician determines that a patient is not an appropriate candidate for treatment, the patient will not receive a prescription. Any refund policies are administrative and do not alter the clinician’s independent medical judgment; results vary and cannot be guaranteed.

What's In The Box

After being approved for the Better U Psychedelic Therapy program, you will receive a Brain Box that includes: 
Blood Pressure Cuff
Meditation Mask
Heart Glasses
Journal + Pen
Medication(s)
App Instructions

Blood Pressure Monitor

Because ketamine therapy can increase blood pressure, we provide every client with a blood pressure monitor to use with the treatments to use with clinical guidance, then logging your blood pressure in the Better U Companion app prior to starting each session.
Touch points every step of the way to provide as much support as you need.
Better U’s treatment framework typically includes an initial period of dose acclimation followed by a time‑limited maintenance plan when clinically appropriate, with the goal of monitoring response and adjusting therapy. Patients may check in with their prescribing clinician on a recurring basis (for example, monthly) to review progress, health changes, and any needed prescription adjustments. Patients may contact the care team between visits with questions or concerns; medical questions are relayed to the clinician for response.  

In addition to medication management, patients may be offered access to integration‑focused coaching and structured psychoeducational materials, including a neuroplasticity‑focused program with self‑guided CBT‑ or psychodynamic‑inspired exercises. Group classes or educational sessions on preparation, integration, and mental‑health topics may be available to support safe and intentional use of treatment. These services are supportive and educational and do not replace individualized psychotherapy unless explicitly provided by a licensed therapist under a separate treatment agreement.
Woman writing in notebook listening to ketamine doctor
Education, Safety, and Support are our top priorities.
Better U clinicians carefully verify medical information to ensure relevant factors are considered before writing a prescription. Better U requires patients using at‑home ketamine protocols to identify an in‑person Peer Supporter—an adult able to be present or available during dosing sessions to help maintain a safe environment—or to use a virtual peer support option when available.Peer Supporters are asked to review educational materials and confirm they understand their role. If a patient cannot arrange in‑person support, virtual peer support with a trained team member may be available during treatment sessions for an additional fee.
Our mission: consistently improving as the industry leader in medically guided, evidence-based, access to breakthrough treatments.

Better U’s curated psychedelic therapy protocol combines ketamine sessions (when appropriate) with psychiatric oversight, personalized coaching, educational classes, and integrative care. Our medical protocol is designed to help patients with treatment-resistant depression, anxiety, or PTSD find relief using the latest breakthroughs in holistic mental health care. We aspire to help patients become less reliant on medication and more focused on self-healing, self-growth, self-love, and self-transcendence. Our goal is to help patients achieve this self-improvement with minimal pharmacological intervention, once or twice a week. Our integration guides will continue to provide ongoing emotional support and educational guidance to improve harmony and balance within. Dosing and frequency are tapered down over time as appropriate.
The Hybrid Model. At home or in-office care, personalized to meet unique needs.

In some situations, clinicians may recommend a hybrid model that combines in‑office and at‑home care.Certain patients may begin treatment in an office setting so their clinician can monitor initial dosing more closely and then transition to at‑home protocols if appropriate.The clinical team reviews patient‑reported outcomes and safety information to decide whether and how to adjust dosing over time.Where available, patients may be referred to local clinics or partner sites for additional in‑person support. SPRAVATO (esketamine) nasal spray, an FDA‑approved medication for treatment‑resistant depression and depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior, may be available in‑office in select states when prescribed and administered under its Risk Evaluation and Mitigation Strategy (REMS) requirements. For important safety information about SPRAVATO, including Boxed Warning and Medication Guide, please see the full prescribing information at the manufacturer’s website.
Girl on couch for ketamine treatment

Revolutionizing Mental Health

Evidence-Based Approaches

Our program includes therapeutic guidance, safety protocols, breathwork, ketamine therapy, virtual treatment preparation and 1-on-1 integration coaching to get the most out of your sessions.
Peer support is required.
Ketamine Therapy is not FDA-Approved for psychiatric conditions and is prescribed off-label. Important Safety Information below: 

Ketamine anxiety icon

Anxiety

Report reduction in symptoms:
Immediately after treatment


85%

1 month after treatment

92%

ketamine depression icon

Depression

Report reduction in symptoms:

Immediately after treatment

81%

1 month after treatment

89%

Shift Your Perspective

Important safety information

What you need to know about these medications
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Important Safety Information:
Ketamine is a prescription medication that is FDA‑approved as an anesthetic and for certain pain indications; it is not approved by the FDA for the treatment of any psychiatric disorder, including depression, anxiety, PTSD, OCD, or other mental health conditions. When ketamine is used for conditions such as depression, anxiety, PTSD, or OCD, this use is considered “off‑label,” and the FDA has not determined that ketamine is safe or effective for these indications or what doses are safe and effective for them. Ketamine therapy is not appropriate for everyone, and no particular benefit, symptom improvement, or outcome can be guaranteed. Individual results vary, and some patients may not experience any improvement or may experience worsening of symptoms.

Key FDA and Safety Considerations

The FDA has specifically warned patients and health‑care providers about potential risks associated with compounded ketamine products and with at‑home use for psychiatric disorders, especially when provided without adequate medical supervision and monitoring.Known safety concerns associated with ketamine products include, but are not limited to, abuse and misuse, psychiatric events (including worsening of psychiatric symptoms), increases in blood pressure, respiratory depression (slowed or difficult breathing), and lower urinary tract and bladder problems.Safe and effective dosing of ketamine for psychiatric indications has not been established by the FDA.Patients should not use ketamine without a prescription and ongoing supervision from a qualified health‑care professional. At‑home administration without appropriate medical oversight can increase the risk of serious adverse events.

Who Should NOT Receive Ketamine Therapy

Ketamine may be unsafe or inappropriate for people with certain medical or psychiatric conditions. Ketamine therapy is generally not recommended for individuals with:
Uncontrolled high blood pressure, serious cardiovascular disease, or significant vascular disease
Serious respiratory disease or conditions that compromise breathing
History of intracerebral hemorrhage, significantly elevated intracranial or intraocular pressure
Moderate to severe liver disease or significant kidney disease
Certain seizure disorders or other serious neurologic conditions
Known hypersensitivity or allergy to ketamine or esketamine
Ketamine therapy is also generally not appropriate for:Individuals who are pregnant or breastfeeding
Children and adolescents, unless specifically determined appropriate by a qualified specialist and consistent with applicable standards and laws
Individuals with active, untreated substance use disorders or a history of ketamine or other substance misuse
Individuals with schizophrenia, schizoaffective disorder, or other psychotic disorders, or with a history of psychosis that is not adequately treated
Individuals with unstable bipolar disorder (particularly with severe mania)Individuals without a suitable diagnosis or treatment rationale consistent with accepted psychiatric standards of care
A licensed clinician must carefully review your medical and psychiatric history, current medications, and overall risk profile before deciding whether ketamine is appropriate. This review may require coordination with your primary‑care or specialty providers and, in some cases, additional medical clearance.

Risks and Possible Side Effects
Ketamine can cause a range of side effects, some of which may be serious. Not all possible side effects are listed here. Possible side effects include:
Dissociation (feeling disconnected from your body, thoughts, or surroundings), altered perception, or confusion
Drowsiness, dizziness, impaired coordination, or difficulty thinking clearly
Nausea, vomiting, or increased salivationIncreased blood pressure and heart rate
Headache or blurred vision
Anxiety, agitation, or other changes in mood
Worsening of depression or anxiety, or new or worsening suicidal thoughts or behaviorUrinary and bladder symptoms (urgency, pain, frequency, or difficulty urinating)
Potential for misuse, abuse, and dependence in some individuals

Serious adverse events can include:
Significant elevations in blood pressure that may increase risk of stroke or other cardiovascular events
Serious breathing problems, including respiratory depression, which may be life‑threatening
Severe confusion, disorientation, or dangerous changes in behavior or judgment
Worsening of underlying psychiatric conditions, such as new or worsening psychosis or mania
Severe bladder or urinary tract problems that may lead to long‑term complications
If you develop concerning or severe symptoms, including difficulty breathing, chest pain, severe confusion, loss of consciousness, urinary problems, or thoughts of harming yourself or others, seek emergency medical help immediately (call 911 or go to the nearest emergency room).

At‑Home Use, Monitoring, and Supervision
At‑home ketamine therapy has additional safety considerations because a clinician is not physically present during dosing. To help reduce risk, any at‑home ketamine treatment delivered through telemedicine or a hybrid model should include:
Careful initial screening and a full medical and psychiatric evaluation by a qualified clinician.
Clear instructions about dosage, timing, and how to take the medication.
Ongoing monitoring of vital signs as appropriate, such as blood pressure and heart rate.
Ready access to your care team for urgent questions or concerns.
A designated support person or “sitter” available during dosing sessions when required by your clinician.
Even with these measures in place, at‑home ketamine remains higher‑risk than in‑clinic administration and may be inappropriate for some individuals. Patients must strictly follow their clinician’s instructions and should never change the dose, frequency, or route of administration without medical guidance.

Misuse, Abuse, and Diversion
Ketamine is a controlled substance with known potential for misuse and abuse. Misuse can include taking higher doses than prescribed, using it more often than directed, taking it without a prescription, or using it for non‑medical or recreational purposes.
Store ketamine securely, out of reach of children, pets, and anyone for whom it is not prescribed.
Never share your medication with anyone else.
Inform your clinician immediately if you feel cravings for ketamine, notice you are preoccupied with taking it, or are tempted to increase the dose or frequency on your own.
Long‑term or repeated high‑dose use of ketamine has been associated with problems such as persistent cognitive changes and severe bladder and urinary tract damage in some individuals.

Driving, Hazardous Activities, and Decision‑Making
Ketamine can impair your ability to think clearly, make decisions, and react quickly. You must not drive, operate heavy machinery, swim, climb, or engage in other potentially dangerous activities for at least the remainder of the day after a ketamine dose, or longer if you still feel any effects, unless your clinician explicitly clears you.
Avoid making major life decisions (such as legal, financial, or relationship decisions) while under the influence of ketamine or immediately afterward.
Not a Substitute for Emergency Care
Ketamine therapy and any associated coaching, integration, or educational services are not a crisis service and are not a substitute for emergency or inpatient psychiatric care.
If you are experiencing a medical or psychiatric emergency—such as chest pain, trouble breathing, signs of stroke, suicidal thoughts, thoughts of harming others, or inability to care for yourself—call 911 or go to the nearest emergency room immediately.
If you are thinking about suicide or are in crisis, you can also contact the 988 Suicide & Crisis Lifeline by dialing or texting 988 in the United States.
Educational Use and No Guarantees
Any descriptions of potential benefits of ketamine therapy on this site are for educational purposes only and are based on evolving evidence, patient reports, and clinician experience. They do not mean that you will experience similar results.

Ketamine therapy is one possible component of a broader treatment plan that may include psychotherapy, lifestyle changes, and other medications. No treatment, including ketamine, can guarantee recovery, prevent relapse, or allow you to stop other medications. Any decisions about starting, changing, or stopping medications should always be made with your licensed clinician.

F
DA warns patients and health care providers about potential risks associated with compounded ketamine products for psychiatric disorders”​FDA alert on compounded ketamine nasal spray
FDA warning about compounded ketamine"
FDA alerts health care professionals of potential risks associated with compounded ketamine nasal spray”
FDA compounding risk alerts hub
https://www.fda.gov/drugs/human-drug-compounding/compounding-risk-alerts​FDA‑approved ketamine
Compounding Risk Alerts

https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/016812s046lbl.pdf

For official FDA information and safety communications related to ketamine and compounded ketamine products, please see the following resources. These external links lead to FDA and manufacturer sites that are not controlled by Better U.


At Better U, we believe that the future of psychedelic medicine require physician collaboration, social enterprise strategies, and a prioritization of patient care over financial gain. This is why we have allocated a large portion of our resources into research studies. We are soon publishing the first ever safety study analyzing the risk profile of our at-home therapy protocol. We plan to share this internal data and conduct IRB studies to advance the acceptance of psychedelic medicine.
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