You do not build up a tolerance to ketamine if you follow the treatment protocol, which dictates a lower dose (around 100mg, give or take for body weight), and one infusion every 3-6 weeks.

Source: Been having regular infusions every 3-6 months for 3 years, and it still works for me.

I can't say this enough: experience & anecdotes based on recreational ketamine use /do not apply at all/ to clinical use.

Of course . I wasn't talking about people on AD treatments but multigram addicts

I have been to a clinic and even weekly doses don't build up tollerance at all which I find very interesting