Safety, risks, and what ketamine cannot do
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.
What ketamine is
Ketamine is an anesthetic, in clinical use since the 1960s and on the World Health Organization’s list of essential medicines. It is a Schedule III controlled substance. We use it at sub-anesthetic doses — well below the dose used for surgical anesthesia — but it is a potent drug and it is regulated as one.
Common effects during and shortly after treatment
- Dissociation — a sense of detachment from your body or surroundings, and altered perception of time. This is expected and typically resolves within an hour of the infusion ending
- Transient increases in blood pressure and heart rate, which is one reason we monitor continuously
- Nausea, which we can prevent or treat
- Dizziness, blurred vision and unsteadiness for several hours
- Feeling emotionally raw or unusually tired the following day
Risks you should weigh
The FDA has identified abuse and misuse, psychiatric events, and increases in blood pressure among the known safety concerns with ketamine. In addition:
- Ketamine has recognized potential for misuse. This is why we administer it only in the office, under supervision, and do not prescribe any take-home formulation
- Long-term data on repeated sub-anesthetic infusion is limited. Frequent high-dose recreational use is associated with bladder and urinary tract injury and with cognitive effects; whether, and at what cumulative exposure, that becomes relevant to supervised therapeutic use is not established
- Ketamine can precipitate or worsen psychotic symptoms in susceptible people
- The dissociative experience is distressing for some people
What ketamine cannot do
- It is not a cure. It is a treatment, and for most people who respond it is a treatment that needs maintaining
- It does not replace psychiatric care, psychotherapy, or your medication. We work alongside those; we do not substitute for them
- It does not work for everyone. A proportion of people get no benefit at all, and we cannot identify in advance who they will be
- It is not FDA-approved for any psychiatric condition or for chronic pain
If you are in crisis
If you are having thoughts of harming yourself, please 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.
We do treat patients with active suicidal thinking, but only on the recommendation of, and in ongoing co-management with, your psychiatrist.
See who is and is not a candidate →
Related pages
The RESTORE Method · Are You a Candidate? · Conditions We Treat · Our Results · Fees
