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Possible Ketamine Side Effects... What You Need To Know

If you're considering ketamine infusion therapy, it's essential to be fully informed about the potential adverse effects, as well as to understand how they compare to more commonly prescribed antidepressants like citalopram.

Ketamine initially used as an anesthetic, is now also utilized for its rapid-acting antidepressant effects, particularly in treatment-resistant depression. It's administered under controlled clinical settings, usually as an infusion into the bloodstream.

Let's go over some of the possible side effects associated with ketamine and then compare them to the side effects associated with a commonly prescribed antidepressant such as Citalopram (Celexa).

Possible Adverse Effects of Ketamine

During a Ketamine Infusion

Ketamine can lead to a range of psychological and physiological reactions. Some individuals experience what's known as "emergence reactions" shortly after administration, which can range from mild dream-like states to more intense hallucinations and delirium. Although this can be unsettling, these effects are typically transient, subsiding within hours.

Cardiovascular responses to ketamine include increased heart rate and blood pressure, which are closely monitored during infusion. Respiratory rate may also increase, but severe respiratory issues are rare and typically associated with higher doses.

On the gastrointestinal front, ketamine can cause symptoms like nausea or vomiting, though these are usually not severe and subside relatively quickly. Some people may experience increased liver enzymes, indicated by transient LFT elevation, but this is generally temporary.

For the renal system, difficulty urinating, known as dysuria, can occur, though uncommon and typically short-lived.

Possible Adverse Effects Associated with a Common Antidepressant

Comparison to Citalopram

Citalopram, a selective serotonin reuptake inhibitor (SSRI), is often prescribed for depression and anxiety disorders. Its side effects can be more diverse, reflecting the broader range of bodily systems that serotonin affects.

Cardiovascular effects such as QTc prolongation, a measure of heart rhythm, can be a concern, particularly in those with preexisting heart conditions. Citalopram may also cause low blood pressure, primarily upon standing, known as postural hypotension, and can influence heart rate.

The drug's neurological effects can include insomnia, confusion, and agitation, which can be particularly distressing for those with anxiety disorders. Sexual dysfunction, changes in menstrual cycles, and urinary issues like increased frequency are other potential effects associated with citalopram, reflecting its influence on the central nervous system.

Regarding gastrointestinal effects, citalopram may cause nausea, dry mouth, and changes in appetite and weight. Other possible effects range from fever and memory issues to skin reactions and vision changes.

A Side by Side Comparision

Adverse EffectKetamineCitalopram
PsychologicalAnxiety, Emergence reactionInsomnia, Confusion, Agitation/Irritability, Abnormal orgasm, Decreased libido, Amnesia, Impotence, Menstrual disorders
CardiovascularIncreased heart rate, Increased blood pressureQTc Prolongation, Chest pain, Hypotension, Palpitations, Postural hypotension, Tachycardia
RespiratoryIncreased respiratory rateTrouble breathing
GastrointestinalAnorexia, Nausea, VomitingNausea, Dry mouth, Increased sweating, Anorexia, Change in weight/appetite, Gastritis
HepaticTransient LFT elevation
NeurologicalHeadache, Dizziness, Somnolence, Blurred vision, Paresthesia, Extrapyramidal disorder
OtherFever, Memory loss, Skin rash/itching, Edema, Purpura, Myocardial ischemia

Overall Consideration

When comparing the two, it's essential to consider the context in which they're used. Ketamine's effects are often immediate and short-lived, typically observed in a clinical setting during and shortly after infusion. In contrast, citalopram's effects can develop over time with daily use and may persist as long as the medication is taken.

Both ketamine and citalopram have their place in treatment protocols and can be effective when used appropriately. While citalopram is taken regularly and can lead to a range of side effects over time, ketamine is administered in a controlled environment, which allows for immediate management of any adverse reactions.

The decision to use either should be made in consultation with a healthcare provider, considering your medical history, current health status, and the severity of symptoms. It's also worth noting that for some, the potential rapid relief with ketamine may outweigh the risks, especially when traditional antidepressants have not been effective.

In summary, both ketamine and citalopram come with their own sets of risks and benefits. A healthcare provider can help you weigh these against your personal health needs to determine the best course of action for your mental health treatment.

Ketamine for Mood Disorders is Considered an "Off-Label" Use

It is important to note that the FDA (Food and Drug Administration) has approved ketamine for certain medical uses, such as anesthesia, but its use for treating mood disorders and chronic pain is considered "off-label." This means that the FDA does not officially approve ketamine for these conditions, but doctors may prescribe it based on evidence that it can be effective. It's been shown to offer rapid relief for certain patients with depression who haven't responded to other treatments due to its unique effects on brain chemicals and receptors. In the case of chronic pain, ketamine may block pain signals and reduce inflammation.

Healthcare professionals should always thoroughly evaluate your medical and mental health history before your therapy and supervise your treatment, so a detailed consultation is essential to weigh the potential benefits and risks. Ketamine, although safe in the proper hands, can have adverse effects if not used correctly and under direct medical supervision.

The bottom line is: to be sure to do your homework before beginning any ketamine therapy and only entrust your care to a certified professional with adequate training and supervised clinical experience in administering ketamine infusion therapy as recommended by the American Psychiatric Association and the American Society of Anesthesiologists.

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