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Who Should Not Get Ketamine Therapy?
Quick Answer
Ketamine therapy and SPRAVATO® are not for everyone, and the screening is the point of the evaluation, not a formality. Uncontrolled high blood pressure, certain cardiovascular and vascular conditions, a history of psychosis, active substance use disorder, pregnancy or breastfeeding, and some other medical situations can rule ketamine-based treatment out or require caution. A psychiatrist at Denver Ketamine Clinic reviews each of these before any session, and the alternatives — FDA-cleared TMS and medication management — are available in the same clinic.
Cardiovascular
Ketamine and esketamine raise blood pressure and heart rate during a session. Uncontrolled hypertension, a recent heart attack or stroke, aneurysmal vascular disease, and similar conditions are reasons for exclusion or careful review; blood pressure is measured before, during, and after every session for everyone.
Psychiatric history
A history of psychosis or a psychotic disorder is a reason for caution or exclusion, because ketamine's dissociative effects can be destabilizing. Active mania is another. Your psychiatrist weighs this against the depression being treated.
Substance use
Ketamine has a potential for misuse and dependence. An active substance use disorder is generally a reason not to proceed; a history in remission is reviewed individually. Treatment is never given to take home.
Pregnancy and breastfeeding
Ketamine and esketamine are not recommended during pregnancy or breastfeeding; the evaluation asks, and the answer changes the plan.
Other medical situations
Severe liver disease, certain neurological conditions, intracranial pressure concerns, and a known hypersensitivity to ketamine or esketamine are among the other items screened. Some medications interact with ketamine; bring a complete list to the evaluation.
SPRAVATO® specifically
SPRAVATO® carries its own labeled contraindications and a boxed warning; see the SPRAVATO® Important Safety Information. Both pathways share the same monitored-session, ride-home requirements; see side effects for what a session involves.
If you are not a candidate
Non-candidacy for ketamine-based treatment does not mean nothing is available. FDA-cleared TMS and accelerated iTBS, and a fresh look at medication, are offered here by the same psychiatrist who did the screening.
Frequently asked questions
Can I get ketamine therapy if I have high blood pressure?
Controlled hypertension is reviewed individually; uncontrolled hypertension is a reason not to proceed until it is managed. Blood pressure is monitored at every session.
Does a past substance use problem rule me out?
A history in remission is reviewed individually; an active substance use disorder generally does rule out ketamine-based treatment. Your psychiatrist will discuss it plainly.
Can I have ketamine therapy while pregnant?
No. Ketamine and esketamine are not recommended during pregnancy or breastfeeding.
What if I'm not a candidate?
TMS and medication management are available at the same clinic, and the psychiatrist who screened you recommends the next step.
The screening is the first part of the evaluation. Request a consultation.
Request a consultation