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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.
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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.
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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.
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Care Process and Touchpoints
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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 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.

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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

Important safety information

What you need to know about these medications
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Important Safety Information: Compounded Ketamine Therapy

Compounded ketamine is not FDA-approved. Ketamine is not FDA-approved to treat depression, anxiety, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), or any other psychiatric disorder. The FDA has not established safe or effective ketamine dosing for psychiatric conditions.

Ketamine can cause serious and potentially life-threatening adverse effects. At-home use presents additional risks because a healthcare professional is not physically present to monitor you or provide immediate treatment. Screening, a support person, and safety instructions do not eliminate these risks.

Ketamine therapy is not appropriate for everyone. A prescription or continued treatment is not guaranteed. Benefits are not guaranteed: symptoms may improve, remain unchanged, or worsen.

FDA Approval, Off-Label Use, and Compounded Medication

FDA-approved ketamine injection is used intravenously or intramuscularly for general anesthesia. It is not FDA-approved for psychiatric disorders or chronic pain. Prescribing ketamine for a condition outside its approved labeling is commonly described as off-label use.

Compounded ketamine tablets, lozenges, and other compounded preparations are not themselves FDA-approved and have no FDA-approved indications or routes of administration. The FDA does not review compounded drugs for safety, effectiveness, or quality before marketing. Compounded medication is not the same as an FDA-approved generic drug.

When the requirements of Section 503A of the federal Food, Drug, and Cosmetic Act are satisfied, qualifying compounded drugs are exempt from certain federal requirements, including premarket approval. This exemption does not mean that the FDA has approved the product, verified its quality, or determined that it is appropriate for you.

Compounding may meet an individual medical need that cannot be met by an FDA-approved medication. It also introduces risks, including contamination or incorrect strength. Your clinician and dispensing pharmacy can explain the specific medication prescribed for you.

FDA Warnings About At-Home Ketamine

The FDA has warned about compounded ketamine used for psychiatric conditions, including oral formulations. Identified concerns include sedation, dissociation, psychiatric reactions, misuse, elevated blood pressure, breathing suppression, and urinary or bladder symptoms. Without an onsite healthcare professional, serious reactions may not be recognized or treated promptly.

A remote appointment, home blood-pressure cuff, or peer support person does not provide the monitoring, emergency equipment, or immediate clinical response available in a medical facility. Discuss whether an in-person setting would be more appropriate for you.

Who Should Not Proceed Without Clinical Evaluation

Do not take ketamine if you have a known allergy to ketamine or an ingredient in your medication, or if an increase in blood pressure would pose a serious medical hazard.

At-home treatment may be inappropriate, require additional evaluation or specialist clearance, or need to occur in a different setting. Tell your clinician before treatment if you have or have ever had:

  • Uncontrolled blood pressure, congestive heart failure, heart failure with preserved or reduced ejection fraction, coronary artery disease, a heart attack, significant rhythm problems, stroke, aneurysm, or other serious heart or vascular disease.
  • Significant breathing problems, sleep apnea, or a history of breathing suppression with medication.
  • Elevated pressure inside the skull or eye, glaucoma, a brain bleed, significant head injury, seizures, or another serious neurologic condition.
  • Liver, bile-duct, kidney, bladder, or urinary tract disease.
  • Hyperthyroidism or another uncontrolled thyroid condition.
  • Schizophrenia, another psychotic disorder, psychotic symptoms, mania, unstable bipolar disorder, or a severe dissociative reaction. Disclose a family history of psychosis or bipolar disorder as well.
  • A substance use disorder, ketamine misuse, problematic alcohol use, overdose, or current detoxification, residential treatment, or intensive outpatient treatment.
  • Any other serious illness, recent hospitalization, or new or unexplained symptoms.

Do not begin or continue at-home treatment while pregnant, breastfeeding, or trying to become pregnant. If pregnancy is possible or suspected, hold treatment and contact your clinician. This adult at-home program is not intended for people younger than 18.

These examples are not a complete eligibility checklist. A clinician must assess your circumstances; absence of a listed condition does not establish that treatment is safe.

Disclose Your History and Report Changes

Provide complete and accurate information during intake, clinical visits, screenings, and ongoing questionnaires. Include all diagnoses, symptoms, allergies, prescriptions, over-the-counter medicines, supplements, alcohol and other substance use, and care received elsewhere. Tell your clinician about new diagnoses or changes even if an earlier screening was normal.

In particular, report new cardiac concerns, cardiology evaluations, medication changes, emergency visits, hospitalizations, or recommendations from another treating professional to stop ketamine.

Do not take another dose while a new safety concern or conflicting treatment recommendation is unresolved.

Contact your prescribing clinician so care can be coordinated, including with an intensive outpatient program (IOP) or substance use treatment team when applicable.

Incomplete information or failure to follow instructions can increase the risk of harm. Your clinician may request records, testing, or specialist input and may pause, modify, or discontinue treatment for safety.

Possible Side Effects and Serious Risks

Possible effects include feeling detached from yourself or your surroundings; altered perception or sense of time; confusion; anxiety or agitation; dizziness; drowsiness; impaired balance, coordination, or judgment; blurred vision; slurred speech; nausea; vomiting; and appetite or saliva changes. Effects and recovery time vary.

Serious complications can include:

  • Breathing or consciousness problems: Excessive sedation, slowed or stopped breathing, choking or aspiration, and loss of consciousness.
  • Cardiovascular problems: Substantial blood-pressure changes, abnormal heart rhythms, or worsening heart disease. Blood-pressure increases may be particularly hazardous for certain patients.
  • Psychiatric reactions: Severe distress, prolonged confusion, psychosis, mania, or worsening mental health symptoms, including suicidal thoughts.
  • Urinary injury: Urgency, frequency, incontinence, painful urination, blood in the urine, reduced bladder capacity, or more extensive urinary tract damage.
  • Liver or bile-duct injury: Abnormalities can occur with recurrent exposure, including use for unapproved indications under medical supervision.
  • Other harms: Allergic reactions, falls and other injuries, misuse, dependence, and cognitive problems associated with frequent or prolonged use.

Severe reactions, overdose, and dangerous substance combinations can be fatal. Long-term safety of compounded ketamine for psychiatric treatment is not established. This page does not list every possible risk or interaction.

Medication, Alcohol, and Substance Interactions

Combining ketamine with alcohol, opioids, benzodiazepines, sleep medicines, or other sedating substances can cause profound sedation, breathing suppression, coma, or death.

Stimulants and other medicines that raise blood pressure may add cardiovascular risk. Disclose ADHD medicines, decongestants, thyroid medicines, antidepressants including MAO inhibitors, theophylline or aminophylline, cannabis, recreational drugs, and all other substances.

  • Avoid alcohol for at least 48 hours before and 48 hours after a session, consistent with your clinical instructions. Do not dose while intoxicated, hungover, or experiencing withdrawal.
  • Obtain an individualized plan for benzodiazepines, stimulants, sleep medicines, opioids, and other potentially interacting medications before a session.
  • Do not independently stop, skip, or change prescribed medication, including benzodiazepines or blood-pressure medication. Abrupt changes can be dangerous.
  • Do not combine ketamine with recreational or illicit drugs. Ask your clinician before starting a new medicine or supplement.

Requirements for At-Home Sessions

Do not conduct a ketamine session alone. A responsible, sober adult peer support person must be physically present during the session and remain available through recovery as directed by your clinician. Virtual Peer Support may also be an option, please ask your medical provider about this.

Virtual Peer Support can also be utilized. See treatment preparation and Peer Support instructions in your app. A support person is not a medical professional and cannot replace clinical monitoring.

  • Complete the required clinical evaluation and preparation. Do not begin until you understand your prescription, monitoring instructions, and emergency plan.
  • Use only your prescribed dose, route, and schedule. Do not take extra medication because effects seem delayed or weaker than expected.
  • Follow the heart-rate and blood-pressure monitoring instructions in your treatment portal, including when to take readings and when to hold treatment. If a reading falls outside the permitted range specified in your portal, or you feel unwell, do not take ketamine and contact your clinical team. Seek emergency care for emergency symptoms.
  • Follow your clinician’s fasting and fluid instructions. If you do not have clear instructions, obtain them before treatment.
  • Use a safe setting away from stairs, pools, baths, weapons, and other hazards. Arrange another adult to care for children or anyone who depends on you.
  • Keep a working phone available. Your support person should know your location, what you took, and how to call emergency services.
  • Complete follow-ups and questionnaires and report adverse effects promptly. Do not continue treatment without required reassessment or monitoring.

Driving, Activities, and Recovery

Do not drive, ride a bicycle, operate machinery, swim, climb, cook over an open flame, or perform other hazardous activities until at least the next day after a full night’s sleep and until you are fully alert and unimpaired. Follow longer restrictions if instructed or if any effects remain. Arrange transportation if needed.

Do not provide sole care for children or dependent adults while impaired. Avoid important legal, financial, or other major decisions during treatment and recovery.

Repeated Treatment and Ongoing Monitoring

Continuing ketamine requires ongoing clinical assessment of benefit, side effects, medical changes, and misuse risk. Your clinician may recommend laboratory testing or other monitoring, including liver testing with repeated treatment.

Report urinary symptoms, persistent cognitive changes, abdominal pain, yellowing of the skin or eyes, or dark urine before another dose.

Feeling better does not establish that continued dosing is safe or that other treatment should stop. Your clinician may change the plan, recommend a different setting, or discontinue ketamine.

Controlled Substance, Storage, and Disposal

Ketamine is a Schedule III controlled substance with potential for misuse and dependence. Tell your clinician if you develop cravings, need progressively more medication, take it outside the prescribed schedule, or have difficulty controlling use.

Store medication securely in its labeled container, following the pharmacy’s instructions, away from children, pets, and other people. Never share, sell, or transfer it.

Do not use medication beyond its pharmacy-assigned beyond-use date. Ask your pharmacy about safe disposal and authorized take-back options.

Emergency Symptoms and Urgent Concerns

Call 911 or go to the nearest emergency department for trouble breathing, inability to wake, loss of consciousness, chest pain, stroke symptoms, a seizure, a severe allergic reaction, dangerous behavior, or immediate risk of harm to yourself or someone else.

Do not drive yourself. Do not wait for a portal response.

For suicidal thoughts or emotional crisis in the United States, call 988, text 988, or use https://988lifeline.org/chat/. If there is immediate danger or a medical emergency, call 911.

For non-emergency concerns, contact your prescribing clinical team through your member portal or the contact method provided in your care instructions. Messages may not be reviewed immediately.

Better U’s platform, coaching, and integration services are not emergency services or a substitute for emergency or inpatient psychiatric care.

Alternatives and Treatment Expectations

Discuss alternatives appropriate to your diagnosis, including psychotherapy, FDA-approved medications, transcranial magnetic stimulation, electroconvulsive therapy, or care in a monitored medical setting when appropriate. Ask about the benefits, risks, and availability of each option.

SPRAVATO® (esketamine) is a different FDA-approved product for specified depressive conditions. It is subject to a restricted safety program requiring administration in a certified healthcare setting and at least two hours of monitoring. It is not the same as compounded ketamine, and its approval does not establish approval of compounded ketamine.

Research findings, testimonials, and descriptions of potential benefits do not predict your response. No treatment outcome is guaranteed. Do not stop other treatment or change medication without discussing it with the relevant prescribing clinician.

Clinical Care and Platform Services

Better U, Inc. provides technology, administrative, educational, and other non-clinical support services. Medical evaluations, diagnoses, prescribing, and clinical treatment decisions are provided by licensed clinicians through affiliated professional medical practices.

Your care documents identify the practice responsible for your treatment. Prescription medication is dispensed by the pharmacy identified on your prescription label.

Coaching, integration support, and educational materials do not replace medical evaluation, clinical monitoring, or emergency care.

This page provides general safety information and does not replace an individualized discussion with your clinician or your medication instructions.

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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. ‍

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