Contraindications

Of course, there are some individuals with specific medical conditions who would not be appropriate candidates for this type of therapy and they would include anyone with:

Hypersensitivity (Allergy) to ketamine:
A recent myocardial infarction – less than 6 months ago,
Unstable Angina or Accelerated Hypertension,
Uncompensated congestive heart failure/pulmonary hypertension,
Known or suspected Cerebral Aneurysm or AVM,
A recent hemorrhagic stroke – less than 1 year ago

Several medications are known to compete at the NMDA and/or D2-3 receptor and therefore limited the clinical effectiveness of ketamine, these include:

Risperdal (risperidone),

Zyprexa (olanzapine),

Lamictal (lamotrigine).

Any patient currently on these medications would require a downward titration leading to a temporary discontinuation for approximately 2 weeks before the infusion series and during the course of ketamine therapy. The medication may be resumed following completion of the infusion series if clinically indicated.

Also the use of benzodiazepines (Valium, Xanax, etc.), are “relative contraindications” and may need to be reduced prior to treatment for maximal benefit.

Please feel free to contact us if you have any questions or would like assistance with medication titrations.   

Rapid Decrease in Depressive Symptoms with an
N-methyl-D-aspartate Antagonist in
ECT-Resistant Major Depression

Ibrahim L, Dizgranados N, Luckenbaugh DA, et al.
Prog Neuropsychopharmacolol Biol Psychiatry. June 1, 2011; 35(4):1155-1159.  

View Article

Rapid antidepressant effects of repeated doses  of ketamine
compared with electroconvulsive therapy in
hospitalized patients with major depressive disorder

Ghasemi M, Kazemi MH, Yoosefi A, et al.
Psychiatry Research 2014; 215: 355-361

View Article