FAQ

Ketamine therapy is a treatment using low-dose ketamine to alleviate mental health conditions like depression, anxiety, and PTSD.

This article from The Washington Post answers the most common questions surrounding Ketamine, including who may benefit from treatment the most. Check it out here: “Who should try ketamine therapy?”

Ketamine is considered to be a safe medication, but may cause some side effects which are usually only present during and shortly after each session.  Side effects usually resolve by the morning after each session.  Side effects are less prevalent when used at the relatively low dosages that we will be using for your treatments.  Side effects lasting longer than 24 hours are rare.  

One of its effects is causing an altered state of consciousness during which there can be dissociative or perceptual changes such as distortion of time and space, feeling detached from reality, feeling separated from the body or in a dreamlike state.  Some describe it as having an out of body experience or report “spiritual” or “mystical” experiences.  These non-ordinary states of consciousness are normal and most people will experience them to some degree during treatment.  Most people find the experience calming, relaxing and pleasant.  They often feel what it’s like to have the absence of anxiety, depression, pain, or suicidal thoughts.  Experiencing quieting of the mind, feelings of love and gratitude is also common.  Feeling differently than we usually feel can show us that it is possible to feel that way and helps the brain to adapt and work towards an improved state of mind. 

As patients face their challenges instead of avoid or suppress them this can result in feeling raw emotions and sometimes reliving past experiences from a different perspective.  We view this as progress but in the moment it can feel overwhelming.  It is best to have a therapist with whom you can further process these emotions.   

The most common undesired effects during and shortly after sessions are nausea, dizziness, fatigue, grogginess, brain fog, elevated heart rate and elevated blood pressure.  We provide medications to prevent or treat nausea and have medications available to treat elevated blood pressure if needed.  Due to some of the effects, patients are not allowed to drive themselves home and are advised to not drive, operate heavy equipment, make important personal or business decisions, or engage in strenuous activities until at least after a full night of sleep and only once they are not feeling impaired. 

During and immediately after a treatment patients often struggle with balance. For this reason we have wheelchairs available if needed.

There is no evidence that controlled/supervised use of ketamine has any long lasting negative effects however long term infrequent use (ranging from once every week to once every 6 months), has never been studied in detail.

In people who have abused ketamine regularly and at high dosages there have been cases of liver damage, impaired cognitive function, and bladder irritation/damage (cystitis).

Ketamine is not recommended during pregnancy.  There is not enough evidence to understand the risk surrounding pregnancy however there is some evidence suggesting ketamine may affect the unborn fetus.

Ketamine is not usually recommended for patients with a delusional disorder such as schizophrenia, active mania, uncontrolled hypertension, hyperthyroidism, active substance abuse (should have completed a detox for at least 1 week before getting treatment), or patients with a history of an aneurysm, heart attack or stroke.

Ketamine is considered to be low risk for dependence.  Lower than alcohol, nicotine and even caffeine. It still can be abused and when used excessively people can develop a psychological addiction. Problems with addiction when following a protocol like ours have not been found. 

There is some evidence that when used properly ketamine is actually helpful in treating addictive behavior.  More evidence is needed before we will treat patients for addiction alone however patients who struggle with addiction and also have a qualifying mental health disorder may receive treatments if our medical provider has recommended it.

Some medications can blunt the benefit of ketamine such as benzodiazepines and Lamictal (lamotrogine).  In general patients are asked not to take a “benzo” right before or during a session.  Whenever possible we recommend patients gradually taper off of benzodiazepines “benzos” under the guidance of a medical professional before or after starting ketamine treatment. These medications have not been shown to provide long term benefit for mental health. Common “benzos” include Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam).  

It may be best to skip a dose of Lamictal just before each ketamine session, but only if your medical provider recommends it. Do not stop medications without discussing it with a medical provider first.

Skin rashes and infections are rare but can occur, especially near the site of injection.  Contact us, or seek care at another clinic or hospital if you have a rash or redness that is worsening.   

Some studies suggest that Ketamine might increase intraocular pressure so if you have glaucoma we recommend consulting with your ophthalmologist to ensure it is controlled before undergoing treatment.

People who normally suffer from sleep apnea may also experience apnea during treatment.  If you have apnea you should discuss this with our treatment team.  We have supplemental oxygen and may put you on oxygen if you are unable to maintain appropriate levels.

Although not common some patients have reported symptoms of bladder irritation after ketamine treatments and have had to stop treatment because of it.  This is similar to something like pineapple.  If you eat some pineapple you can tolerate it but if you have too much pineapple it may cause sores in your mouth.  We recommend patients drink a lot of fluids and eat healthy foods immediately after each ketamine session.  

Although rare, an anaphylactic reaction is possible.  We keep epinephrine available in the clinic at all times to treat an anaphylactic allergic reaction.

Ketamine therapy is generally safe when administered by professionals. It can be effective, but results vary among individuals, and maintenance sessions may be needed. If you have concerns about ketamine treatment, please reach out to us and schedule a consultation.

Ketamine likely works by affecting brain neurotransmitters, promoting new neural connections, and rapidly relieving symptoms.