Is Ketamine Therapy For Depression Safe?

Is Ketamine Therapy For Depression Safe?

As ketamine has become more widely available as a treatment for PTSD, anxiety, and depression, you may have looked into receiving the treatment yourself. If you’re learning about ketamine treatment for the first time, you may be wondering, is ketamine therapy for depression safe?

The short answer is yes, ketamine therapy, when performed by a reputable clinician in a controlled environment, is safe. While IV Ketamine infusion therapy for depression is considered an off-label use of the drug, it is a legal and FDA-approved medication that’s considered one of the safest anesthetics available. That said, it is not entirely without side effects, and it is not right for everyone.

Though ketamine has been in use since its approval in the 1970s, it’s important to understand the potential risks and — even more so — to ensure the benefits outweigh them.

To help us address the risks of ketamine and the safety and efficacy of the drug, we’ve gathered opinions from medical experts across the country. Here’s what they had to say about the safety of ketamine therapy for depression.

RELATED: How Ketamine Treatment For Anxiety Works, Per Medical Experts

Dr. Jonathann Kuo – Hudson Mind

Ketamine gives the gift of dissociation from the conscious mind. Many patients feel like they are able to step outside of themselves for the first time. This distancing effect opens the door to new perspectives and insights into life experiences. But to help patients get there we first have to create an environment conducive to letting go of outcomes. The onus is on practitioners to maximize the journey by designing experiences that emphasize safety and comfort.

— Dr. Jonathann Kuo

Dr. Jonathann Kuo is the founder and medical director of Hudson Mind. As a board-certified Pain Management Specialist and Anesthesiologist, Dr. Kuo has over a dozen years of experience working across Interventional Orthopedics, Regenerative Medicine, and Interventional Mental Health. From leading active research and administering thousands of Dual Sympathetic Blocks and ketamine infusions, Dr. Kuo has emerged as a mental health innovator and thought leader. At Hudson Mind he works with renowned psychiatrists, neurologists, and functional medicine specialists to bring interventional treatments to the forefront of modern mental health care.

Dr. Steven L. Mandel – Ketamine Clinics Los Angeles

Ketamine is an extremely safe medicine. It has been administered hundreds of millions of times since it was FDA approved in 1970. The amount of safety and efficacy data exceeds that of most medicines since ketamine was the most widely used anesthetic in the world for several decades. Ketamine Infusion Therapy for depression and other mood disorders is an off label use. This is common practice in the US and in particular for behavioral health, as one in three psychiatric medications are prescribed off label. This use is a much smaller dose than the amount of ketamine that has traditionally been administered. There are over 160 research papers published and underway proving the safety and efficacy of ketamine specifically for depression and other mood disorders. At Ketamine Clinics Los Angeles, we have treated more than 4,000 patients and have seen zero long-term side effects or other significant issues as a direct result of the treatment.

— Dr. Steven L. Mandel, M.D.

Dr. Steven L. Mandel, M.D., is an internationally recognized expert and pioneer in the use of ketamine infusion therapy to treat mental health disorders and chronic pain. Dr. Mandel has more than 40 years of experience utilizing ketamine as a board-certified anesthesiologist. He also earned his master’s degree in psychology. He is the founder and president of Ketamine Clinics Los Angeles, a leading ketamine infusion therapy clinic in Southern California.

Dr. Rafael F. Cruz – Kentuckiana Ketamine Institute

Ketamine therapy is the safest, most convenient and fastest acting anti-suicidal and anti-depressant available today. It is transforming mental health challenges often with the first treatment.

— Dr. Rafael F. Cruz, M.D.

Dr. Rafael Cruz, M.D., is a nationally recognized leader in Integrative Medicine. As a researcher, educator and clinician, Dr. Cruz has the credentials and experience that inspire confidence. In his private practice, Kentuckiana Integrative Medicine, he provides a spectrum of advanced health solutions with an integrative, holistic focus. He believes in blending the best aspects of conventional / traditional medicine with Natural / Integrative Medicine.

William Beesley, M.S. – Restorative Health

We utilize a system called, an industry-leading clinical decision support system to stay continuously informed of the best peer reviewed research from leaders in our field. Our clinic policy aligns with the research from David Feifel, Ph D, MD | David Dadiomov, PharmD, BCPP | Kelly C. Lee, PharmD and their teams at University of California, San Diego.

I’ll paraphrase the conclusion of their paper:

‘The risks associated with administering ketamine for depression are minimal and reasonable if patients are treated in a monitored setting to reduce the negative aspects of transient elevated blood pressure and experiences of dissociation. Both of these risk factors can be highly disturbing for the patient and indicate the need for this treatment to be administered in a medically supervised setting.’

We look forward to participating in future studies regarding Ketamine | Telemedicine & Follow up Appointments. My hypothesis would be that doing certain follow up appointments via telemedicine after a patient has demonstrated that they don’t pose an elevated blood pressure or dissociative risk will be a measurable net positive for patients outcomes and satisfaction without an increased risk profile for patient safety.

— William Beesley, M.S.

William Beesley, M.S., is the founder of Restorative Health Primary Care in Sandy, Utah. Restorative Health offers a wide range of mental health services, including ketamine treatments. They are based in Sandy, Utah.

RELATED: What Are The Biggest Misconceptions About Ketamine Therapy?

Sean McLean – Catalyst Clinic

At Catalyst Clinic, we follow the standard IV Ketamine protocol of six infusions over 2-3 weeks. We’ve served over 1,000+ patients and have seen a remarkable success rate of 85 percent with minimal to no side effects outside standard post-sedation complications like nausea and headaches. Based on our experience, IV Ketamine treatment for depression is as safe or safer than any other mental health treatment option.

— Sean McLean

Sean McLean is a Registered Nurse Anesthesiologist. McLean has over four years of treating mental health conditions with IV Ketamine. He co-founded Catalyst Clinic, a Ketamine IV Infusion and Functional Medicine clinic in Pleasant Grove, Utah.

Dr. Antonio Ocana – Pasithea Clinics

Ketamine is an FDA approved medication, re-purposed from anesthesia, but we use it at much lower doses in psychiatry. It is considered a psycho-plastogen, which means it creates the plasticity that we can use in psychotherapy to heal people. It’s like a fresh covering of snow, it covers old tracks and creates the opportunities for new thinking. Ketamine literally stimulates the brain to grow new connections. This allows people to see old problems in a new light.

In our clinic, Ketamine is administered by IV infusion, because it is associated with the best outcomes but it is associated with some risk, as would any infusion treatment, that is why it is administered by an experienced physician. Ketamine can raise your heart rate, so it might not be the right treatment for people with severe heart disease. On the positive side: It leaves the body quickly, so patients can be on their feet within an hour or two, and ketamine is not addictive in the usual sense.

Ketamine is a powerful drug, and it needs to be used with caution. But done properly, it is exceptionally safe. Because ketamine is administered intravenously, the infusion can be controlled, stopped if needed.

Safety is job one. Physical risks are mitigated by having the infusion administered by an anesthesiologist and monitored by an ICU nurse. If an adverse event were to occur, you are surrounded by clinicians who know exactly what to do. Mental risks are mitigated by being paired with a trained psychotherapist who is skilled at managing any mental challenge.

Ketamine has dramatic effects, compared to other anti-depressants. It works faster, better in some cases and addresses the most difficult conditions, depression, anxiety, PTSD, chronic pain, and addiction. Many people with these conditions are stuck. They can’t seem to move forward despite their best effort. Ketamine gets them un-stuck. If you can leverage that moment of plasticity, you can make impressive advances with people who have made no progress in years.

— Dr. Atonio Ocana

Dr. Radowitz – Nushama

Ketamine does not reduce one’s respiratory drive, heart function, or ability to swallow, making it a very safe and common choice for use with children in emergency and operating rooms… At the turn of the millennium, ketamine was found to have profound and fast-acting antidepressant effects. Subsequent studies found it helped many people with depression so severe that the condition did not respond to any other treatment modality—60 to 70% of participants showed an antidepressant response. Ketamine was also found to be very fast-acting, with effects observed within a matter of hours after administration. This is compared with the several weeks that traditional antidepressants can take to have an effect. In 2019, the FDA approved s-ketamine for treatment-resistant depression, and it is currently prescribed off-label for many mood disorders.

— Dr. Radowitz

Dr. Radowitz has a wealth of experience seeing the effects trauma can have on our physical health firsthand. He joined Nushama to oversee and develop treatment modalities, believing psychedelics are the future of mental wellness as current solutions treat symptoms, not underlying issues. 

Kendall Miller – Healing Ketamine

Yes it absolutely is. The only time I would say to be careful is if someone is acutely suicidal. If they are actively in that space, then ketamine can give them enough energy to go through with it. If you are treating suicidal thoughts and depression, it can pull them out of the hole they’re in.

— Kendall Miller, CRNA, BLS, ACLS

Kendall Miller, CRNA, BLS, ACLS, is a skilled nurse anesthetist at Healing Ketamine in Orem, Utah. He’s been practicing anesthesia in various settings for more than 20 years.

Healing Maps Editorial Staff

Healing Maps Editorial Staff

View all posts by Healing Maps Editorial Staff

The Healing Maps Editorial Team has decades of experience across all facets of the psychedelic industry. From assessing studies and clinic research, to working with clinician's and clinics, we help provide data-backed information to psychedelic-curious individuals across the globe.

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