Ketamine therapy safety information.
Ketamine is a well-studied medication with a long clinical history. Like any medication, it carries potential risks and is not appropriate for everyone. This page explains what patients should understand before, during, and after treatment.
In an emergency, call 911 or 988.
This website and program are not intended for use in medical or psychiatric emergencies. If you or someone you know is in immediate danger, call 911. For mental health crises, call or text the 988 Suicide & Crisis Lifeline.
Enrollment requires a comprehensive medical evaluation.
Before any prescription is written, a licensed clinician reviews your medical history, mental health history, current medications, and treatment goals. Some patients are not appropriate candidates. That screening is a core safety step.
Potential side effects
Most side effects from low-dose oral ketamine are mild and short-lived. Individual experience varies. Report any effect that concerns you to your provider.
Temporary changes in blood pressure and heart rate
Ketamine can transiently raise blood pressure and heart rate. Providers screen for cardiovascular conditions before prescribing.
Nausea
Mild nausea is one of the more common reported effects, particularly during the first sessions. Simple measures often help.
Dizziness or light-headedness
Some patients report feeling unsteady during and immediately after a session. Rest and hydration are typically recommended.
Dissociation
A sense of emotional or perceptual distance from the body or surroundings can occur. At low oral doses, this is usually mild and time-limited.
Sedation and drowsiness
Sessions often produce a calm, sleepy feeling. Plan to rest for the remainder of the day.
Headache
Some patients report headaches during or after a session. Persistent or severe headaches should be reported to your provider.
Vivid dreams or altered sleep the following night
Sleep patterns may shift temporarily. Report significant or ongoing sleep disruption to your provider.
Urinary tract issues at high or long-term recreational doses
This has been observed with heavy, unsupervised use rather than low-dose supervised programs — but is part of why dosing and duration are carefully managed.
Who should not use ketamine
Ketamine may not be appropriate for people with the following conditions or situations. This list is not exhaustive; final determinations are always made by the prescribing provider.
- Uncontrolled cardiovascular disease or uncontrolled hypertension
- History of severe cardiac arrhythmias without cardiology clearance
- Active psychosis or a history of psychotic disorders
- Active mania or uncontrolled bipolar disorder
- Active pregnancy or breastfeeding
- Certain active substance use disorders (as assessed clinically)
- Known allergy or hypersensitivity to ketamine
- Certain interacting medications (assessed during intake)
Medication interactions
Several classes of medications and substances may interact with ketamine. Always bring a complete and up-to-date medication list to your evaluation. Never adjust or discontinue a prescribed medication on your own — any changes should always happen under the supervision of the prescribing provider.
- Benzodiazepines (may blunt therapeutic effects and increase sedation)
- Opioid medications (increased sedation risk)
- MAOIs and certain psychiatric medications
- Some blood pressure medications
- Other CNS depressants
- Alcohol and recreational substances
Driving & day-of restrictions
Do not drive, operate machinery, sign legal documents, or make major decisions on the day of a session. Plan for rest, quiet, and hydration. Because sessions happen at home, you do not need to travel.
Monitoring & support
Your provider will explain the specific check-in cadence for your plan, what to monitor between sessions, and how to reach the care team through secure messaging. Report new or worsening symptoms between sessions — do not wait for the next appointment.
When to seek immediate medical care
Call 911 or go to the nearest emergency department if you experience:
- Chest pain, severe shortness of breath, or fainting
- A severe or unrelenting headache unlike your usual pattern
- Persistent vomiting or inability to keep fluids down
- Confusion, disorientation, or a change in consciousness that does not resolve
- Thoughts of harming yourself or others
Questions about safety?
Bring them to a discovery call, or read our full FAQ.
Book a discovery call