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Are you a candidate?

Not everyone is. Here is how we decide — before you spend anything.

Ketamine is FDA-approved as an anesthetic. It is not FDA-approved for depression, anxiety, PTSD, or chronic pain, and its use for those conditions is off-label. Individual results vary and cannot be predicted in advance.

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You may be a candidate if

• You have depression, bipolar depression, anxiety, or PTSD that has not responded adequately to at least two medication trials, or to psychotherapy, rTMS, ECT, or esketamine (Spravato)
• You have chronic neuropathic pain — fibromyalgia, peripheral neuropathy, complex regional pain syndrome — that has not responded to conventional management
• You are under the care of a psychiatrist or prescriber, or are willing to be. We work alongside that person; we do not replace them
• You can arrange three consecutive days, and someone to drive you home after each session

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We will not treat you if you have

These are absolute. We will tell you on the phone, before you travel and before you pay anything.

Heart and circulation

• Rapidly worsening or uncontrolled high blood pressure, or unstable angina
• A recent heart attack or stroke
• An aneurysm or abnormal blood-vessel formation in the brain
• Fibromuscular dysplasia
• Narrowing of the aortic valve
• Hypertrophic cardiomyopathy — thickened heart muscle
• Pulmonary hypertension

Inherited conditions

• Polycystic kidney disease, or vascular Ehlers-Danlos syndrome (type IV) — both carry a high risk of aneurysm
• Multiple endocrine neoplasia type 2
• The BDNF met/met genetic variant, which is associated with not responding to ketamine

Mental health and medication

• Psychosis or schizophrenia
• Delusional disorder or depersonalization disorder
• A substance use disorder that is not in remission
• Current treatment with lamotrigine (Lamictal), which can block ketamine’s effect

Pregnancy

• Pregnancy, IVF treatment, or breastfeeding

Allergy

• A known allergy to ketamine. This is genuinely rare — six cases have been reported and one confirmed.

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Things we work through with you first

These do not rule you out. They change how we plan treatment, and we deal with them before your first infusion rather than discovering them afterwards.

Heart and circulation

• High blood pressure that is not well controlled
• A heart attack or stroke further in the past
• Previous surgery inside the skull
• A pituitary tumour, or SIADH

Liver, kidney and blood

• Significant liver disease
• Significant kidney disease
• Taking anticoagulants, or a bleeding disorder

Hormones and metabolism

• Thyroid over- or under-activity that is not well controlled
• Diabetes that is not well controlled
• The BDNF val/met variant

Mental health and medication

• Borderline personality disorder, antisocial personality disorder, or intermittent explosive disorder
• Kratom use (mitragynine)
• A substance use disorder in remission
• Higher-dose benzodiazepines, which reduce the response — timing can sometimes be adjusted, but only with your prescriber

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If you are having thoughts of suicide

Tell us. We do treat patients with active suicidal thinking — but only on the recommendation of, and in ongoing co-management with, your psychiatrist. We will not take this on alone, and we would not be doing you a service if we did.

If you need help today, call or text 988 to reach the Suicide and Crisis Lifeline, or go to your nearest emergency department. Ketamine therapy is scheduled care and is not a substitute for emergency treatment.

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What we will not do

• We will not treat you if we do not think you are likely to benefit, however much you want us to
• We will not treat you without records. If a provider is willing to give you ketamine without reviewing your history, that is worth knowing about them
• We do not prescribe take-home ketamine in any form — no lozenges, no nasal spray, no oral formulation
• We will not advise you to stop or reduce psychiatric medication. That is your prescriber’s decision

Do not stop or change the dose of any prescribed medication on your own. We will speak to the physician who prescribes it directly if that would help.

Related pages

The RESTORE Method  ·  Conditions We Treat  ·  Safety, Risks and Limits  ·  Fees  ·  Our Results