A closer look at the safety concerns around ketamine for depression.
Ketamine therapy is no longer on the fringes of mental health. The Anxiety & Depression Association of America called the treatment a rising star in the clinical mental health world, with more patients seeking ketamine as an alternative to SSRI medications and talk therapy. And in major cities across the country, ketamine clinics are springing up, as answers to the growing rates of depression. Though this psychedelic therapy has gained wider recognition, questions about safety persist, including Is ketamine therapy addictive? This article will explore some of the potential risks—and benefits— you should consider before seeking out ketamine therapy for depressions.
What Is Ketamine Therapy?
Ketamine was first introduced in clinical settings in the 1960s and then achieved FDA approval in 1970. Though it was first developed as an anesthetic, research dating back to the 1970s found that some anesthetic ketamine patients also experience improvements in their mental health. Since then, ketamine has been increasingly studied for its effects on conditions like depression, anxiety, and PTSD.
Ketamine therapy for depression works by influencing brain chemicals that help with mood and communication between brain cells. It blocks a receptor called NMDA, which increases the release of another chemical called glutamate. This, in turn, activates different brain pathways that help repair and strengthen connections between brain cells. These effects can lead to rapid and long-lasting improvements in mood.
Unlike traditional antidepressants, which can take weeks to work, ketamine therapy for anxiety and depression often provides rapid relief—sometimes within hours. This makes it a valuable option for individuals with treatment-resistant depression.
Is Ketamine Addictive?
Ketamine is not generally considered to be a highly addictive substance—chemically speaking. Though it can activate the brain’s reward system by increasing dopamine, a chemical linked to pleasure and motivation, research indicates that ketamine does not cause long-term changes in the brain’s addiction-related pathways like other addictive substances. But, this does not mean that there isn’t the potential for misuse and dependency. And there are documented cases of tolerance and dependence from prolonged use.
Matthew Perry’s ketamine-related death in 2023 reignited conversations about the drug’s safety. While concerns are especially high for individuals with a history of substance use disorder, even those without prior addiction can be at risk of misuse if ketamine is not carefully managed.
This is why medical supervision is essential. Undergoing ketamine therapy in a clinical setting ensures careful dosing and monitoring, reducing the risk of dependence and adverse effects.
Medical Use vs. Recreational Use
There’s a significant difference between clinical ketamine treatment for depression and illicit ketamine use.
Medical use: Administered in a healthcare setting under professional supervision, typically through IV infusions, nasal sprays, or injections. Doses are carefully regulated to maximize benefits while minimizing risks.
Recreational use: Often involves snorting or taking large doses for hallucinogenic effects, which may increase the likelihood of addiction and harmful side effects.
Recognizing Signs of Ketamine Misuse
Although ketamine therapy is generally safe when takenunder medical supervision, misuse can occur. Watch out for these warning signs of potential abuse:
- Frequent cravings for ketamine outside of prescribed treatments
- Using ketamine in higher doses or more often than recommended
- Seeking ketamine from non-medical sources
- Experiencing withdrawal symptoms, such as mood swings or anxiety, when not using ketamine
Additional Ketamine Safety Concerns
While ketamine therapy is generally safe under medical supervision, some side effects can occur, including:
- Dizziness
- Nausea
- Dissociation
- Hallucination
- Increase in blood pressure
- Increase in blood pressure
- Dissociative effects
- Increase in heart rate
Why Medical Supervision Matters: A trained provider can monitor these effects, adjust dosages as needed, and ensure that ketamine is administered safely.
Ketamine Infusions vs. Nasal Spray: Which is Safer?
Both ketamine therapy infusions and Spavato esketamine nasal spray are effective treatments for treatment-resistant depression. Since they act on the brain in similar ways, both have the potential for misuse if taken outside of a medical setting.
In clinical environments, trained providers carefully monitor dosing and patient response to ensure safety.
One potential advantage of esketamine nasal spray is that it has a higher potency and stronger affinity for NMDA receptors, which may allow for effective treatment at lower doses compared to IV ketamine. However, there is no single “right” way to receive ketamine therapy—only the right approach for you. A licensed medical provider can help determine which treatment best aligns with your needs and goals.
So, is ketamine safe? Can it lead to dependence or addiction? The answer depends on how it’s administered. In a clinical setting, licensed providers follow strict safety protocols to minimize risks and ensure patient well-being. But with ketamine therapy expanding rapidly—sometimes called the “wild west” of mental health treatment—choosing a reputable provider is more important than ever.
The best approach isn’t just about receiving the drug; it’s about working with a clinician who monitors your treatment, prioritizes safety, and integrates other therapeutic tools for long-term success.
Interested in learning more about the benefits of ketamine therapy for depression and anxiety? Schedule a consult with our clinical team to see if this therapy is right for you.
