Who Is Not a Good Candidate For Ketamine Therapy?


Factors that may impede an individual from experiencing the benefits of ketamine therapy. They could include active substance abuse, unstable medical conditions, pregnancy, or breastfeeding.

Psychologists usually perform an in-depth evaluation before prescribing ketamine to patients. This process includes conducting physical exams and reviewing the medical histories of the individuals in question.

Substance Abuse

Ketamine has been used as a dissociative anesthetic in medical settings since the 1970s. However, it is becoming an increasingly popular way of treating depression and other conditions not helped by traditional antidepressant drugs or talk therapy treatments such as anti-depressants. Additionally, ketamine may reduce memories that cause drug abuse in some individuals.

However, suppose you have a history of substance or alcohol abuse. In that case, your psychiatrist is unlikely to recommend this form of therapy as it contains powerful dissociative medications that could easily be misused outside a clinical setting. Furthermore, it could be dangerous if other medical conditions exist, such as hypertension or cardiovascular disease, as receiving this treatment could place them at greater risk.

Psychologists typically conduct an intensive screening process before prescribing this medication, including asking you questions about your health, medical history, and lifestyle as well as performing a physical exam to ascertain whether ketamine infusion therapy would provide relief from symptoms. If not deemed an ideal candidate for such treatment, your psychiatrist will likely suggest alternative therapies as possible solutions.

Although most individuals who seek ketamine treatment experience some improvement from their symptoms, ketamine therapy is only meant as a short-term fix for anxiety and depression sufferers; cognitive behavioral therapy or other forms of talk therapy may be needed to address underlying causes that trigger anxiety or depression.

Treatment-resistant anxiety and depression should consider this option, provided they have a precise diagnosis without major physical complications. If conventional approaches have not provided relief, an infusion with ketamine could be necessary to start feeling better again – make sure that any concerns or adverse reactions related to other medications have been discussed beforehand with their healthcare providers before embarking on such a journey.

Cardiovascular Issues

Ketamine is a type of anesthetic first employed by doctors when they realized its potential to enhance neural plasticity in patients and speed their recovery timeframes. Unfortunately, like other anesthetics, ketamine may cause unwanted side effects, such as hallucinations, elevated blood pressure or heart rate increases, disassociation, and cognitive dysfunction, in some people. Furthermore, this medication should not be taken by those with unmanaged cardiac issues such as heart failure or arrhythmias as this will increase body workload and may aggravate their problems further.

People with cardiovascular conditions may not be suitable candidates for ketamine therapy because this treatment has been known to increase stress hormone levels in the body. In particular, it has been known to raise blood pressure temporarily. Therefore, medical professionals typically monitor this number during ketamine infusion sessions; some even provide medications to lower it.

People with high blood pressure are at increased risk of stroke and other adverse symptoms if their blood pressure suddenly fluctuates unexpectedly, which is why medical professionals may advise alternative treatments that do not carry as high a level of risk.

Importantly, it should also be noted that ketamine should never be administered while pregnant or breastfeeding as research shows it could potentially harm an unborn fetus or nursing infant. Therefore, pregnant and breastfeeding women should explore other treatments that won’t put themselves or their infant at greater risk.

Before initiating ketamine infusion therapy, it is also vital that you discuss any medications you are currently taking with your physician. Ketamine may interact with certain drugs and cause unwanted side effects, for instance, increasing the effectiveness of antidepressants while potentially leading to seizures when combined with barbiturates or benzodiazepines; it may even interfere with how the liver processes other drugs.


Medication may be one of the primary factors preventing someone from being eligible for ketamine therapy. Ketamine can cause sedation, making it less suitable for those taking sedatives such as Xanax or other benzodiazepines such as Ambien. Ketamine also increases blood pressure, which could be problematic if someone already suffers from high blood pressure, so all medications, vitamins, and supplements you are taking must be disclosed so the doctor can create a mental health plan tailored specifically to you and your needs.

Many psychiatrists advise patients to try alternative therapies before considering ketamine therapy, such as SSRIs, TMS, or CBT. Unfortunately, many of these treatments require regular sessions with a doctor or therapist; therefore, ketamine may not be an appropriate choice for you.

One condition renders individuals poor candidates for ketamine therapy: pregnancy. Ketamine should never be taken during gestation as its safety has yet to be proven, so if you’re expecting or planning to become pregnant soon, it would be wiser to wait until after giving birth before beginning this treatment plan.

Ketamine infusions may cause various potential side effects, including visual issues, dizziness, nausea or vomiting, confusion, amnesia, bladder pain (interstitial cystitis), increased heart rate, and blood pressure. Most of these side effects occur during treatment and usually last a short while before subsiding.

Sometimes, these side effects can lead to an allergic reaction that could prove fatal. If any of these symptoms appear, contact your physician immediately. Often, it takes up to 24 hours after your first ketamine infusion before an allergy test can be conducted. Multiple infusion sessions will likely be necessary before realizing the maximum benefit.


Due to ketamine’s dissociative psychotropic properties and its use as an agent of abuse in party settings, pregnant women are advised against receiving this treatment. Pregnancy is an integral time in both motherhood and fetal development; medications that could hinder this could have adverse side effects; unfortunately, the FDA hasn’t classified ketamine into its pregnancy risk categories yet so there is no way of knowing its potential short-and long-term impacts on pregnant women taking ketamine during gestation.

Ketamine should also not be taken by women who are breastfeeding. Studies have demonstrated that small amounts may make their way across the blood-placental barrier into breast milk; thus, if a mother needs treatment for posttraumatic stress disorder or depression using this drug, she should wait until after breastfeeding has finished before beginning any medication with it.

Ketamine has proven effective at treating postpartum depression (PPD) among women who have previously experienced it; however, many doctors remain cautious when prescribing it to pregnant patients due to the increased risks associated with neonatal toxicity during labor and delivery that could result in low muscle tone in newborns – commonly referred to as “floppy baby syndrome.”

Case reports detail one patient who received repeated ketamine intramuscular injections to treat PPD during pregnancy. On her flight from Houston to Texas Children’s Hospital, however, she experienced late decelerations in her heart rate that required medical intervention despite prophylactic IV fluids and oxygen use; consequently, she needed an emergent cesarean section, which ultimately resulted in Apgar scores between one and two upon delivery of her fetus.

Pregnant women or those planning to become pregnant should avoid receiving ketamine treatment as its potential risks outweigh its benefits for them. Antidepressants and talk therapy may offer better options. Furthermore, those with psychotic or substance abuse histories should not receive this drug as its use could worsen these symptoms.