Is Ketamine Therapy Safe? Here’s What To Know

Ketamine therapy is safe when administered under medical supervision, with patient screening, dosage control, and monitoring. Learn more about the process and how BNI Clinics...

Ketamine therapy is safe when administered under medical supervision, with patient screening, dosage control, and monitoring. Learn more about the process and how BNI Clinics oversees careful and effective treatment.

Key Takeaways

  • Ketamine therapy is safe when it is medically supervised and includes patient screening, dosage control, and vital sign monitoring.
  • Although it is safe, be aware of contraindications that could prohibit use. It also produces common side effects. Serious risks are rare and can be minimized with medical supervision.
  • The therapy is recommended for people with treatment-resistant depression and other mental health conditions. It produces a glutamate surge for rapid relief.

Table of Contents

Introduction

Ketamine is growing in popularity as a solution for treatment-resistant depression, but is it safe? Safety depends heavily on medical supervision. It should be administered after a thorough clinical screening and with vital sign monitoring.

Is ketamine therapy safe? Ketamine can help you achieve higher levels of wellbeing

This article provides more information about ketamine, ensuring people dealing with severe depression can access safe treatment.

What Is Ketamine Treatment?

Ketamine treatment is prescribed for treatment-resistant depression, which is diagnosed when a person does not respond to two or more depression treatments. A JCP safety study found the overall antidepressant response rate was 67% (65 of 97 participants).

The therapy may also help with other mental health disorders, like anxiety and post-traumatic stress disorder, and chronic pain conditions.

Unlike traditional antidepressant medications, which make serotonin and/or norepinephrine more readily available and can take weeks to work, it produces a glutamate surge that ultimately increases synaptic growth and plasticity and produces results in hours to days.

Ketamine can be administered as follows:

  • Nasal Spray: Spravato (esketamine) is an FDA-approved nasal spray
  • IV Ketamine Therapy: An off-label alternative to the nasal spray
  • Intramuscular Injection: Another off-label administration method

Note: insurance coverage is typically not available for off-label treatment. Contact BNI Clinics for an insurance verification– we’ll tell you exactly what’s covered.

Routine treatment typically includes six sessions across 2-3 weeks. Follow-up sessions are usually required.

Ketamine treatment is safe when clinically administered by a licensed professional after a careful screening to ensure proper dosage and monitoring to prevent complications. When used recreationally, none of that applies, and there is no guarantee of safety or purity.

Why Is a Patient Screening Important?

A screening ensures the patient is suited to ketamine treatment. It will check for the following conditions:

  • Physical Conditions such as liver issues, cardiovascular conditions, and high blood pressure can cause complications during treatment.
  • Mental Health Conditions: In rare cases, ketamine may increase psychiatric symptoms in people with a history of psychosis, which is why screening for psychiatric history is a standard part of the intake process.
  • Pregnancy: Ketamine is generally not recommended during pregnancy due to limited safety data — patients should discuss this with their doctor.

Other contraindications exist. Professionals at a ketamine clinic will examine the patient and take blood work to ensure a safe process.

What Is Considered in Dosage Control?

Clinicians must also ensure a safe dosage by considering the client’s height, weight, and condition. Ketamine was first introduced to the medical world as an anesthetic, but when used to treat major depressive disorder, doses are much lower.

Typically, therapy starts at a low dose, which is adjusted based on response. Standardized, evidence-based dosing guidelines from clinical trials and FDA labeling for esketamine may serve as reference points.

What Does Monitoring During Treatment Entail?

Monitoring means that on-site clinical staff are available to track vital signs and the effects of ketamine during and after treatment. Here’s what it entails:

  • Continuous vital sign monitoring of blood pressure, heart rate, and oxygen saturation
  • On-site clinical staff: Typically, a physician, nurse, or anesthesiologist is present to ensure safety
  • Managing dissociative side effects: These effects may occur and can become risky if the patient becomes unresponsive, loses awareness of surroundings, and experiences intense hallucinations. At controlled, sub-anesthetic doses used in clinical settings, this level of dissociation is uncommon, but continuous monitoring and trained staff further reduce risks.
  • Post-session observation period before discharge: Patients typically stay at the clinic 30 minutes to two hours (depending on administration type) after treatment to ensure they are ready to go home. Driving is not recommended, so clinicians should confirm that someone can drive the patient home.

What Are the Common Side Effects and Serious Risks of Ketamine Treatment?

A patient relaxes while receiving ketamine therapy

While mostly safe, with a review of multiple studies cited in ClinicalTrials.gov documentation showing only 9 of 450 healthy participants reported adverse mental status events such as hallucinations or dysphoria, ketamine can produce certain side effects and, in rare cases, serious risks, as follows:

  • Short-term: Dissociation, nausea, elevated blood pressure, dizziness
  • Rare but serious: Cardiovascular events, bladder issues (with chronic/high-dose use), psychological distress

Supervised settings mitigate these risks, making it safer than unsupervised use.

How Can I Ensure Regulatory and Clinical Oversight?

The best way to ensure regulatory and clinical oversight is to work with a licensed provider that maintains documented protocols for screening, dosing, and emergency response. A licensed physician, nurse practitioner, or anesthesiologist should administer treatment or directly supervise it.

Oversight also differs by treatment type.

Spravato (esketamine) is available only through the FDA’s Spravato REMS (Risk Evaluation and Mitigation Strategy) program, a restricted-distribution system that requires clinics to be specially certified, patients to be enrolled in a monitoring registry, and every session to be documented and reported.

IV and intramuscular ketamine, by contrast, are used off-label, meaning no equivalent federal program exists, and each clinic sets its own screening, dosing, and monitoring protocols. This is why patients should verify credentials and ask about monitoring procedures before starting treatment, regardless of which method they choose.

BNI Clinics Guide Safe Ketamine Mental Health Treatment

BNI Clinics offers a safe ketamine treatment process, with an experienced, board-certified team, a safe, controlled, medical environment, and personalized treatment plans. We carefully screen each patient before treatment begins and guide them through a safe process. Therapy and other medications are included to ensure a whole-person approach.

Contact us to learn how we support our clients’ mental wellbeing.

FAQs

Is ketamine therapy safe?

Yes, ketamine therapy is safe when administered under medical supervision by licensed providers who follow proper patient screening, controlled dosing, and continuous monitoring protocols. Risks increase significantly outside supervised medical settings or when combined with other substances.

What’s the difference between Spravato and ketamine infusion therapy?

Spravato (esketamine) is FDA-approved for treatment-resistant depression and is administered as a nasal spray under a restricted REMS program with mandatory in-clinic observation. IV infusion ketamine is used off-label for depression, anxiety, PTSD, and chronic pain and is not FDA-approved for these conditions, so oversight and protocols vary by clinic.

Who shouldn’t undergo ketamine therapy?

Ketamine is not recommended for people with uncontrolled hypertension, severe cardiovascular disease, a history of psychosis or schizophrenia, aneurysmal vascular disease, or a history of intracerebral hemorrhage. Pregnancy, active substance use disorders, and certain eye conditions (like glaucoma) also require careful evaluation before treatment.

What are the common side effects of ketamine therapy?

Short-term side effects can include dissociation, nausea, dizziness, elevated blood pressure, and mild disorientation. These typically resolve within a couple of hours after the session ends.

How is a patient monitored during a ketamine session?

Staff track vital signs (blood pressure, heart rate, oxygen saturation) continuously, remain present throughout, and observe patients for a period after the session before discharge.

Sources

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