The 7 Types of People Who Should NOT Get Ketamine (2022 Update)
Editor’s Note: This blog was originally published on March 23, 2018 and has been updated on August 8, 2022 to reflect the latest research, insights, and best practices in ketamine therapy.
We are amazed and grateful for the transformation ketamine catalyzes in people’s lives. For some, ketamine can rapidly reverse symptoms of depression or can alleviate chronic pain in a way other medications can’t. While it can do so much for some, it can be harmful to others. It’s no surprise we love ketamine, but we equally honor the Hippocratic Oath, which includes, “Do No Harm”. In this blog, we are going to discuss the 7 types of people who should not undergo ketamine infusion treatments.
As a friendly reminder, although we will be discussing several medical conditions in which ketamine should be avoided, each individual is unique and requires evaluation by a medical professional. Please be advised to see your own physician as this blog is no substitute for actual medical evaluation.
Here are the 7 types of people who should NOT take ketamine:
Ketamine can cause an increase in both blood pressure and heart rate, which is dangerous for patients with uncontrolled high blood pressure.
1. People with Uncontrolled High Blood Pressure (Hypertension)
Ketamine is known to increase blood pressure, and in the setting of already high blood pressure, the increase could get so high as to cause a heart attack or stroke. Therefore it is standard practice for your blood pressure to be monitored throughout the infusions. How often your blood pressure is measured during the treatment varies from clinic to clinic. Medical professionals are very aware that the blood pressure can go up during the infusion, and some might give medications during the treatment to lower it. The concern is especially for those who have a history of high blood pressure that is not controlled with medication or are not on medication.
People with unstable heart disease shouldn’t get ketamine infusions as ketamine can increase heart rate and cardiac output, which could worsen various heart conditions.
2. People with Unstable Heart Disease (such as Arrhythmias, Congestive Heart Failure, Coronary Artery Disease, etc.)
Ketamine can increase heart rate and cardiac output (i.e. how hard your heart is working). With the heart working harder due to ketamine or is overworked, there could be a worsening of various heart conditions. Some clinics, like ours, use a machine called an ECG (electrocardiogram) which monitors your heart and can alert the medical staff if there are concerns.
Ketamine’s effect on the cardiovascular system can worsen a situation already compromised by an uncontrolled thyroid issue.
3. People with Untreated or Uncontrolled Thyroid Disease (especially Hyperthyroidism)
In thyroid diseases such as hyperthyroidism, the body may already have an increased heart rate i.e. sympathetic overdrive which could be worsened with taking ketamine. The concern with this thyroid condition is related to high blood pressure and unstable heart disease. If the thyroid issue is not stabilized, there could be a potential increase in blood pressure as well as overworking the heart. The idea here is to have the thyroid properly addressed, so that the blood pressure and heart can be within safe levels during the infusion.
Any substance that can alter a person’s senses has the potential for addiction, and this includes ketamine.
4. People with Active Substance Abuse.
Ketamine is used to treat addiction, however infusions are usually given once the patient has detoxed or is off of the drugs the individual is addicted to. When a person is taking multiple drugs, the way their body may react may be unpredictable and potentially life-threatening. Treatment of addiction can be complex, especially when utilizing a medication such as ketamine that does have a low potential of addiction and has a history of being a recreational drug.
Doctors have also used ketamine to treat bipolar disorder; however, we do not recommend ketamine for those experiencing mania, active psychosis, or unstable cardiovascular disease.
5. People in an Active Manic Phase of Bipolar Disorder
Ketamine can cause an altered mental state. If a person is already in an active manic state, ketamine could potentially worsen or enhance a worrisome emotional state. That being said, there is research supporting the role of treating depression for those with bipolar disorder when they are in a depressive phase.
Ketamine induced non-ordinary states of consciousness could worsen active delusions or hallucinations. The keyword here is ‘active.’
6. People with active delusions and hallucination symptoms (who are not taking prescription medications for treating these symptoms or those who are taking street drugs)
Similar to the point made in #5, a person can experience out-of-body experiences or similar non-ordinary state experiences when given ketamine. Ketamine could potentially enhance or worsen delusions and active hallucinations, which could put others and/or the individual in harm's way.
You may want to think twice before restarting ketamine treatments if you had a bad reaction to ketamine in the past.
7. Patients Who Have Tried Ketamine in the Past and Had A Bad Reaction
Common short term side effects are nausea, dizziness, and headaches. For some, there are long term side effects which they can no longer tolerate like interstitial cystitis. If someone has been given ketamine for a procedure and had an adverse effect, we would suggest holding off.
Learn more about the common side effects of ketamine, both short term and long term, here at our blog.
To have the safest experience while receiving ketamine infusions, you should undergo a fairly comprehensive medical history to screen for the above medical scenarios. The vast majority of clinics do this. Being honest about your current physical and emotional state will better ensure a safe outcome.
Fret not if you find yourself in one of the above categories. Improvement or stabilization in your medical condition could potentially open the door for you to receive ketamine infusions later. Until then, we recommend you continue to take care of yourself by following up with your health care professionals.When looking for a place to receive infusions, not only do we recommend that you find a place where you feel emotionally safe, but also one that keeps you physically out of harm’s way.
Curious about how to find the right ketamine clinic for you? Check out our blog on this very topic!
Ketamine is no doubt an amazing and effective treatment that has transformed people’s lives. However, inasmuch as we wish that ketamine could be for everyone, it isn’t. In this blog, we talk about certain conditions that should not be paired with ketamine.