Is ketamine safe?

Ketamine is a relatively safe medication when administered by a medical professional, with the proper training, and ability to medically screen someone for ketamine treatment.  As with any controlled substance, there are always concerns for potential abuse, however ketamine has been shown to be safe and effective when used appropriately and under medical supervision.  Here are some key points about the safety of ketamine:

  1. Proper medical screening: This is the most important aspect of administering ketamine.  As we want to make sure that whoever receives the medication does not have any underlying medical conditions that may put the patient at risk.  Ketamine stimulates sympathetic drive increasing heart rate and blood pressure.  Therefore, ruling out any uncontrolled cardiovascular disease in patients is key.  Clients with a history of high blood pressure are able to receive ketamine treatment safely as long as their condition is controlled and stable.  Patient with any history of psychosis, delusions, manic episodes must also be looked at carefully as ketamine (like any psychedelic) has the potential for worsening underlying psychotic symptoms.  

  2. Short-Term Side Effects:  The main side-effects we see with ketamine are usually short lived in nature.  For example, about 1 in 20 patients may experience a form of nausea.  This can be mitigated by pre-treating patients with anti-nausea medications that allows the treatments to proceed without much discomfort, if any.  Other side-effects such as blurry vision are typically mild and temporary, and they usually subside within a few hours after treatment.

  3. Low Risk of Overdose: Unlike opioids and other sedatives, ketamine has a wide safety margin, meaning that it is difficult to overdose on the drug. Even if someone takes too much ketamine, it is unlikely to cause serious harm or be fatal.

  4. Low-Addictive Potential:  I think it is misleading when other sites/clinics say that ketamine is non-addictive.  Because that is not true.  Like anything that can be used as a form of escapism ketamine can be addictive.  I tend to say that the potential for addiction is much lower than other medications that are widely prescribed (stimulants, benzodiazepines).  It is therefore not considered to be highly addictive or habit-forming as other substances that activate dopamine reward pathways such as cocaine or methamphetamine.  In fact, studies have shown that ketamine may actually have anti-addictive properties and may be useful in treating addiction to other substances. 

  5. Limited Long-Term Effects: There is limited research on the long-term effects of ketamine use, but what is known suggests that the drug is relatively safe when used as prescribed.  The key here is as prescribed.  When people abuse ketamine and start taking high doses regularly there is high risk of cognitive impairment and permanent bladder dysfunction.  However typically the bladder issues are only seen after years of misuse.    

 In summary, while ketamine is not without risks, it is generally considered to be a relatively safe medication when used appropriately and under medical supervision. As with any medication, it is important to discuss the potential benefits and risks of ketamine treatment with a healthcare professional and to follow their instructions carefully.  This is why we prioritize the screening process as the most important step in terms of safety. 

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