Understanding Ketamine Therapy Contraindications: Who Should Avoid Treatment?
As a ketamine therapist, I’ve seen firsthand how transformative ketamine-assisted therapy can be for individuals struggling with conditions like depression, anxiety, and PTSD. When used appropriately and under careful supervision, ketamine has the potential to unlock new pathways to healing. However, as with any treatment, there are important contraindications to be aware of to ensure the safety and well-being of my clients. Here’s an overview of the key considerations.
1. Serious Cardiovascular Issues
Ketamine can cause an increase in heart rate and blood pressure, which makes it unsuitable for clients with severe cardiovascular conditions like uncontrolled hypertension, heart failure, or a history of heart attack or stroke. Before proceeding with ketamine-assisted therapy, clients receive a full assessment with a medical doctor to ensure it's safe for them to use ketamine.
2. History of Psychosis or Severe Mental Health Disorders
While ketamine can be an incredible tool for mental health treatment, it also has the potential to trigger or worsen symptoms in individuals with a history of psychosis, schizophrenia, or bipolar disorder. The dissociative and perceptual effects of ketamine may not be well-tolerated by these individuals and could lead to adverse reactions. This is one of the key areas where I exercise caution and always make referrals to specialists if I believe someone may be at risk.
3. Liver Dysfunction
Ketamine is metabolized through the liver, so clients with liver conditions need careful consideration before starting therapy. In cases of liver disease or impaired liver function, ketamine may not be processed properly, leading to potential toxicity or increased side effects. If indicated, I collaborate with a client’s healthcare provider to ensure their liver function is in a safe range before beginning treatment.
4. Pregnancy and Breastfeeding
Given the lack of extensive research on ketamine’s safety during pregnancy or breastfeeding, I typically advise against its use during these times unless absolutely necessary. If a client is pregnant or nursing, we work together to explore alternative therapies that might be safer for both the client and the baby.
5. History of Substance Use Disorder
Ketamine is classified as a dissociative anesthetic, and while it’s not typically addictive in the same way other substances are, there is always a risk for misuse, particularly in individuals with a history of substance use disorder. I always conduct a thorough intake to assess for any past substance abuse issues and, if relevant, refer clients to appropriate addiction specialists.
6. Severe Kidney Disease
Although less commonly discussed, ketamine can impact kidney function, especially in those with pre-existing kidney issues. If a client has severe kidney disease, I strongly recommend we avoid ketamine therapy or monitor their renal function closely. This is another area where communication with other healthcare professionals is crucial.
Wrapping Up
As a ketamine therapist, my goal is to ensure that my clients are fully informed and safe when considering sublingual ketamine as part of their treatment plan. I take time to carefully evaluate any contraindications and work closely with the physician to ensure we're providing the best possible care. If you’re considering ketamine therapy, it’s important to discuss your medical history in detail and ensure you’re a good candidate for the treatment.
If you're ever unsure about whether sublingual ketamine is right for you, reach out. I’m here to guide you through the process and make sure you're on the path to healing in the safest way possible.
