Who is Not a Good Candidate for Ketamine Therapy?

Ketamine assisted psychotherapy is surging in popularity as a safe and effective way to treat resistant or refractory mental health disorders. That being said, it is not for everyone. In this article, we will review current recommendations for the use of this drug, as well as criteria you can use to determine who is not a good candidate for ketamine therapy. 

Current Supported Uses of Ketamine Therapy

While the FDA has approved the use of intranasal ketamine for only two diagnoses (treatment-resistant depression and acute suicidal ideation), there is a wealth of clinical research and anecdotal evidence to support its use in a wide variety of mental health conditions. These include:

• PTSD
• Chronic Pain
• Addiction
• Bipolar Disorder
• Anxiety

There are also early trials examining ketamine as a means of treating eating disorders. We expect research to continue to unveil this drug as a good alternative therapy for many other diagnoses as well. 

Who Should Not Take Ketamine?

Your provider will take a thorough medical history to review any conditions that may be contraindicated with taking ketamine. Certain diagnoses can be worsened by ketamine. The following diagnoses may be used to decide who is not a good candidate for ketamine therapy:

High Blood Pressure

If your blood pressure is uncontrolled with other medications, your mental health professional may recommend against ketamine assisted psychotherapy. This is because ketamine naturally raises the body’s blood pressure, even in low doses. Your counselor may suggest you speak with your primary care physician about controlling your blood pressure prior to attempting ketamine therapy. 

Hyperthyroidism

Thyroid disorders, especially hyperthyroidism, often present with heart and blood-pressure related symptoms. Individuals with untreated hyperthyroidism, for example, may experience episodes of tachycardia (fast heart rate). Elevated heart rate is associated with increased blood pressure, which will be further aggravated by ketamine (see above). Therefore, your mental health provider may advise you to seek treatment for your thyroid issue prior to any ketamine therapy, especially since thyroid disorders can mimic the symptoms of anxiety and depression. 

Active Substance Abuse Disorder

Sobriety status can also be used determine who is not a good candidate for ketamine therapy. While ketamine can help treat addiction, it is usually not started until a patient has detoxed from drugs or alcohol. If used when a patient is still under the influence of other substances, it can produce unpredictable and even life-threatening side effects. 

Uncontrolled Heart Conditions

Ketamine can increase the heart rate, making it work harder. This is not ideal for individuals with unmanaged heart conditions, such as congestive heart failure, arrhythmias, or coronary artery disease. You will need to have such conditions well under control before it is safe to try ketamine assisted psychotherapy. 

History of Adverse Reactions to Ketamine

Ketamine has been used in operating rooms since the 1970s as a dissociative anesthetic. If you had a procedure where ketamine was used and you experienced a long-term negative side effect, such as kidney damage or seizures, you may not be a good candidate for ketamine therapy. Even the low-dose used in KAP could increase damage already done, so you will need to carefully weigh the pros and cons of its use with your doctors. 

Ketamine Assisted Psychotherapy in Destin

The above conditions are not the only ones used to decide who is not a good candidate for ketamine therapy. Again, your mental health provider will conduct a thorough review of your medical history to determine if this is an appropriate and safe treatment option for you.  If you are experiencing a mental health disorder that is not getting better with traditional methods, like anti-depressants, please call The Crane Center. We offer many alternative treatment options, including KAP for eligible patients. Call or go online today to schedule a consultation with one of our fantastic providers.