Who Should Avoid Ketamine Therapy: Identifying Inappropriate Candidates

Estimated read time 13 min read

The popularity of ketamine therapy has surged in recent times due to its groundbreaking approach towards treating various health issues. However, it should be noted that this treatment strategy may not yield positive outcomes for every individual. Thus, the focus of this article is to highlight how one can identify unsuitable individuals for ketamine therapy and equip them with accurate information and practical expectations accordingly.

To determine who should avoid undergoing ketamine therapy, it’s essential to comprehend its purpose. Though originally designed as an anesthesia drug, recent research highlights that this medication can alleviate depression symptoms and chronic pain while treating certain mental illnesses too. Nevertheless, due to its varied mechanisms of action and individualistic responses from patients, there are categories of people ineligible for this treatment approach. Keep reading to explore the individuals unable to participate in ketamine-based therapies further.

Pre-existing Health Conditions

Doctor holding heart model

Certain health conditions can significantly impact the suitability of an individual for ketamine therapy:

Cardiovascular Diseases

When considering ketamine therapy, it is crucial to exercise caution if you have a history of cardiovascular disease. This treatment can cause an increase in heart rate and blood pressure, potentially endangering those with pre-existing heart conditions. The following are key points to bear in mind:

  • Increased Heart Rate: Ketamine can cause tachycardia, which is an elevated heart rate. This reaction may be especially concerning for individuals with pre-existing cardiac conditions as it could put additional strain on the heart and potentially lead to complications.
  • Elevated Blood Pressure: Ketamine has the potential to augment blood pressure, which could be an unwelcome experience for people who are afflicted with hypertension or elevated blood pressure.
  • Risk of Cardiac Events: Individuals with pre-existing cardiovascular conditions are at a higher risk of experiencing cardiac events, such as arrhythmias or heart attacks. This is due to the combination of elevated heart rate and blood pressure that they may have.

Individuals who have had cardiovascular illnesses before considering ketamine therapy should go through a thorough medical assessment and seek guidance from healthcare providers. They must meticulously weigh the possible risks and benefits of this treatment, as well as other available options.

Severe Liver Issues

Individuals with severe liver impairment must exercise caution when undergoing ketamine therapy due to the liver’s crucial role in metabolizing this medication. Before selecting such a treatment option, it is essential to bear these significant factors in mind.

  • Metabolism of Ketamine: Ketamine metabolism occurs primarily in the liver. If there is severe hepatic dysfunction, this process may impede proper drug breakdown within the body.
  • Prolonged Effects: Ketamine’s prolonged and unpredictable effects may arise from reduced liver function, potentially leading to overdose or negative reactions.
  • Monitoring and Dosage Adjustment: Individuals with liver issues may require careful monitoring and dosage adjustments to ensure their safety during ketamine treatment.

Before starting ketamine treatment, it is recommended that those with serious liver issues seek guidance from a healthcare specialist. The medical expert can assess the state of their liver and determine if this therapy is appropriate for them. Additionally, alternative treatments may be proposed in certain cases.

Psychotic Disorders

Individuals who have experienced psychotic episodes, such as schizophrenia or psychosis, are commonly counseled to abstain from ketamine treatment because of the ensuing considerations:

  • Exacerbation of Psychosis: The use of Ketamine may lead to the aggravation of previously existing psychotic symptoms due to its ability in inducing altered perceptions, dissociation and hallucinations.
  • Risk of Agitation: There is a possibility of heightened restlessness and confusion in people with psychotic disorders due to the psychoactive properties of Ketamine, which could potentially deteriorate their state.
  • Safety Concerns: Safety is a paramount concern when it comes to administering ketamine therapy to individuals with psychotic disorders, as they may be more susceptible to negative psychological reactions and thus require careful monitoring.

Prior to considering ketamine therapy, it is essential that those with psychotic disorders communicate their medical background and existing condition to a mental health professional or psychiatrist. It is recommended that alternative treatments customized to meet their particular requirements are investigated instead.

Substance Abuse History

It is advisable for people with a background of drug or alcohol addiction to be careful when contemplating the use of ketamine treatment. The possibility exists that ketamine could lead to addictive behavior and induce yearnings or regression in those who are on their way towards recovery. Important factors to bear in mind:

Risk of Relapse

For individuals with a past of substance abuse, the psychoactive effects of Ketamine may potentially cause relapse. It is imperative to acknowledge these factors:

  • Cravings and Triggers: The utilization of Ketamine may generate impulses and stimuli for individuals in recuperation from substance abuse, resulting in cravings and triggers. As a dissociative agent, ketamine can potentially prompt the search for comparable modified psychological states through their prior abused substances among some persons.
  • Psychological Vulnerability: Individuals who have a past of substance abuse are susceptible to psychological vulnerability upon encountering substances that alter one’s mind. The hallucinogenic impacts of ketamine may amplify their emotions and thoughts, potentially elevating the probability for an individual to relapse.
  • Social Influences: People undergoing recovery often have to steer clear of surroundings and social groups that encourage substance abuse. The introduction of ketamine therapy may require cautious evaluation of likely pressures that could compromise their progress in recuperation.

Thorough Assessment

Prior to initiating ketamine therapy for people with a background of substance abuse, it is imperative to conduct a thorough evaluation of their past use. This analysis must encompass:

  • Substance Abuse Timeline: It is crucial to have knowledge of an individual’s previous substance abuse including the nature and duration, as different drugs may impact physical and mental health differently. Understanding a detailed history can aid in identifying potential risks related to ketamine therapy.
  • Previous Relapses: Reviewing any past relapses and their triggers can provide insights into an individual’s vulnerability to substance use. This information helps in tailoring the ketamine therapy approach to minimize the risk of relapse.
  • Current Recovery Status: Assessing an individual’s current status in their recovery journey is crucial. It includes evaluating the duration of abstinence, participation in support groups or therapy, and overall emotional stability.
  • Co-occurring Mental Health Conditions: Substance abuse often co-occurs with mental health disorders. Identifying and addressing these underlying issues is essential before initiating ketamine therapy. Co-occurring conditions can influence the safety and efficacy of the treatment.

Informed Decision-Making

In making a decision about ketamine therapy, it is important for the individual to collaborate with their healthcare provider and any addiction specialists involved in their care. The process should be guided by informed decision-making that takes into account certain key elements such as:

  • Discussion of Risks and Benefits: It is important to have a comprehensive conversation about the advantages, drawbacks, and other potential options related to ketamine therapy. Effective management of expectations and avoidance of obstacles necessitate open and truthful communication with individuals.
  • Tailored Treatment Plan: The treatment plan will be tailored to meet the individual’s specific needs and risk factors through customization of their ketamine therapy plan. This could include modifying dosages, session frequency, or implementing other forms of treatment in combination with ketamine therapy.
  • Ongoing Monitoring and Support: Regular monitoring and support are essential during ketamine therapy. Addiction specialists can play a vital role in tracking progress, identifying warning signs, and offering guidance when needed.

Pregnancy and Breastfeeding 


Due to inadequate research on the impact of ketamine therapy during fetal and infant development, pregnant women as well as nursing mothers are typically cautioned against participating in such treatments. The absence of safety information has brought up concerns regarding potential hazards.

Pregnancy and Ketamine Therapy

The developing fetus is at high risk of being affected by external factors during pregnancy. There are concerns about the impact that ketamine, mainly used as a dissociative anesthetic and painkiller, may have on fetal development. It’s important to keep in mind certain aspects when considering its effects.

  • Limited Research: The available studies on the impact of ketamine on fetal growth are inadequate. Hence, medical professionals frequently discourage its usage during pregnancy due to the lack of clarity regarding its safety concerns.
  • Possible Teratogenic Effects: Substances known as teratogens can lead to birth defects. Ketamine’s potential for causing such effects is still unclear due to insufficient research, prompting concerns over its safety when it comes to the healthy development of fetuses.
  • Neurodevelopmental Concerns: The impact of ketamine on the developing brain raises serious concerns surrounding neurodevelopment. The delicate nature of the growing nervous system makes it susceptible to disturbances that could result in enduring developmental setbacks. However, there is a lack of clarity regarding how exposure to ketamine during pregnancy affects its mechanisms and outcomes.
  • Potential for Preterm Labor: There is a possibility for preterm labor due to ketamine according to certain studies. Giving birth prematurely can result in several health concerns for the infant, such as delayed development, respiratory complications and lasting disabilities.
  • Psychological Impact: The mental state of the mother during pregnancy may be impacted by Ketamine’s psychoactive features, which can result in psychological distress. Such a situation could have adverse effects on not only the well-being of both the prospective mother and her developing fetus.

Breastfeeding and Ketamine Therapy

It is crucial to carefully contemplate the effects of medications and therapies during breastfeeding. Ketamine, in particular, raises special concerns as it may be secreted into breast milk. Pertinent considerations regarding ketamine use while breastfeeding include:

  • Excretion in Breast Milk: Ketamine has been observed to be excreted in breast milk, which implies that if a lactating mother receives ketamine treatment, her baby may ingest the medication while breastfeeding.
  • Infant Exposure: Infants who are exposed to ketamine via breast milk may exhibit symptoms, such as sedation and changes in mental states that can be troubling for both the mother and child.
  • Lack of Safety Data: The absence of comprehensive safety information on the use of ketamine during breastfeeding, similar to pregnancy, poses a challenge in accurately evaluating its potential hazards.
  • Alternative Options: Breastfeeding mothers are recommended to explore alternative remedies or therapies that are deemed safer while nursing. Seeking advice from a healthcare provider may also be beneficial in making informed decisions.

Age Restrictions

The safety and effectiveness of ketamine therapy can be greatly affected by age. Hence, it is imperative to assess the eligibility of young children as well as older individuals individually when considering this treatment method.

Young Children

The safety and effectiveness of ketamine therapy in very young children have not undergone extensive research. Therefore, it is difficult to precisely determine the risks and benefits of this treatment for them. The important aspects are as follows:

Age GroupConsiderations
InfantsDue to their physiological systems being underdeveloped and inability to communicate discomfort or experiences effectively, the usage of ketamine therapy is not recommended for infants.
ChildrenIn rare instances, for kids who are typically over 6-7 years old, undergoing ketamine therapy may be an option under strict medical observation. Nonetheless, the benefits and drawbacks should be thoroughly evaluated while exploring alternative treatment methods first.


The effects of ketamine therapy may be influenced by age-related physiological changes. The elderly should take note of the following important factors:

Age GroupConsiderations
SeniorsIt is recommended to exercise caution while considering the use of ketamine therapy in older adults because age-associated ailments, including weakened liver function and cardiovascular disorders, could affect ketamine metabolism. It is important to carry out a comprehensive evaluation of any simultaneous illnesses and devise an individualized care strategy for optimum results.

Psychological Readiness

Determining a patient’s eligibility for ketamine therapy heavily relies on their mental health stability. Those excessively afflicted by intense psychological distress may not qualify as optimal recipients for this form of treatment.

Psychological Readiness

Determining a patient’s suitability for ketamine therapy heavily relies on their mental health stability. When patients experience severe mental health crises, they might not be the ideal candidates for this treatment method. As such, it becomes critical to ensure that individuals are psychologically ready before undergoing ketamine therapy since it significantly impacts their overall well-being.

Mental Health Crisis

Individuals who are going through severe mental health crises may display a plethora of disturbing symptoms such as profound restlessness, false beliefs, perceptual distortions or suicidal ideation. In these instances, ketamine treatment might not be suitable for the following reasons:

  • Exacerbation of Symptoms: The dissociative impact of Ketamine is acknowledged to have the potential to exacerbate pre-existing symptoms related to mental health or result in troubling encounters for an individual. This intensified state of dissociation may not be beneficial towards their general psychological wellness.
  • Inadequate Mental State: When a patient is in crisis, their mental state may not be suitable for the introspection and self-examination that ketamine-assisted therapy typically calls for. To obtain maximum therapeutic advantages from ketamine treatment, it’s necessary for individuals to have a reasonably steady mental condition.

Pre-Treatment Assessment

It is essential to conduct a comprehensive psychological evaluation before contemplating ketamine therapy. Mental health experts should assess the patient’s existing mental state, psychiatric history, and possible hazards related to using ketamine. The objective of this assessment is to ascertain whether the person qualifies for ketamine treatment or if there are better alternative interventions available.

Alternative Interventions

In situations where mental health crises are severe, alternative interventions may be prioritized over immediate administration of ketamine therapy. These substitutes can encompass:

  • Hospitalization: Hospitalization becomes necessary if a patient’s critical condition poses risks to themselves or others, requiring immediate care and stabilization.
  • Crisis Counseling: During moments of severe anguish, speedy support and direction can be obtained through accessing crisis counseling or intervention services.
  • Medication Adjustments: In certain instances, modifying current psychiatric medication or investigating alternative options may aid in relieving acute symptoms and stabilizing the individual.


It is essential to identify unsuitable candidates for ketamine therapy in order to guarantee its reliability and safety. Despite it delivering encouraging outcomes for most people, a thorough evaluation of an individual’s health profile is necessary before considering this treatment method. It’s advisable that one confers with medical experts prior to embarking on ketamine therapy so as to determine if it suits their unique condition well enough.


Is ketamine therapy suitable for treating all kinds of depression?

Ketamine therapy should be approached with caution by those who have bipolar disorder or a prior history of manic episodes, despite being effective for many.

Can I safely undergo Ketamine therapy if I have a previous epilepsy record?

Individuals who suffer from epilepsy should generally steer clear of ketamine treatment due to its likelihood to provoke seizures.

Is there an age limit for ketamine therapy?

Generally, it is not advisable for young children or seniors to consume it, but this can vary based on personal situations.

Is it possible for me to have ketamine therapy if I previously struggled with substance abuse?

Individuals who have previously struggled with substance abuse must communicate this information to their healthcare provider due to ketamine’s potential for causing addiction.

Would undergoing ketamine therapy pose a risk for an individual having heart issues?

It is advisable for individuals with cardiovascular concerns to be careful as it could affect their heart rate and blood pressure.

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