Who is Not a Good Candidate for Ketamine Therapy?

Who is Not a Good Candidate for Ketamine Therapy?

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Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). Recreational use of ketamine is illegal in all US jurisdictions. The information in this article is for patients considering assisted psychotherapy with a licensed medical professional, where medical applications of ketamine are studied and approved. We do not recommend or condone recreational ketamine use.

Ketamine therapy is growing in popularity as an alternative therapy to treat a range of mental health conditions. Ketamine is legal for medical use in the United States and available to licensed providers.

But is ketamine therapy appropriate for everyone or are there certain groups or conditions that make it riskier? Has clinical research identified which groups may be the best candidates for ketamine therapy? And how do real medical ketamine users describe their experience?

In this article we’ll answer all of these questions and more. We will analyze medical studies on ketamine therapy to first determine if it’s effective at all, and then to give our opinion on whether certain groups may be better or worse candidates than others for ketamine therapy.

We’ll also feature an unsponsored medical ketamine user’s review and description of their experience.

Does Ketamine Improve Mental Health?

As we documented in our ketamine review article, this chemical compound has been studied in clinical trials for its effects on depression, anxiety and a host of other mental health conditions.

A 2020 meta-study reported that ketamine was effective in relieving depression symptoms, and was particularly shown to be effective in patients who were unresponsive to pharmaceutical antidepressants.

A clinical trial published in the Journal of Psychopharmacology suggests that ketamine may be beneficial for patients with anxiety.

After three months of weekly ketamine injections administered by a licensed medical professional, 18 of the 20 patients studied reported significant reductions in anxiety, and “marked improvements in functionality and in their personal lives.”

A 2021 systematic review found ketamine to have favorable results in patients with bipolar depression.

61% of patients receiving ketamine experienced a reduction in baseline depression severity by at least 50%, compared to only 5% of patients receiving a placebo.

Based on the available research, we consider ketamine to be promising for the treatment of a wide range of mental health conditions, when properly administered in a clinical setting.

But are there certain individuals or groups that may not be ideal candidates for ketamine therapy? We’ll analyze the research and share our thoughts in the next section of this article.

Who Might Ketamine Not Be a Fit For?

Patients with cardiovascular disease or high blood pressure may not be a good fit for ketamine therapy.

As we documented in our review of online ketamine therapy platform Mindbloom, heart rate and blood pressure are clinically shown to increase during ketamine use, and can also increase after-the-fact.

The clinical trial on ketamine for anxiety that we cited in the previous section found that both systolic and diastolic blood pressure levels increased by around 10 mmHg after 30 minutes.

This may not be an issue in patients with normal blood pressure levels, but may push patients with higher blood pressure into a dangerous range.

Ketamine may not be a good option for individuals who suffer with psychosis, given that ketamine use can trigger psychotic symptoms, as documented by a 2018 medical review on the side effects of ketamine.

However, for the most part, further research is needed to confirm at-risk groups for ketamine therapy.

A 2022 medical review concluded the following:

“In patients receiving ketamine for pain, predicting who may be more likely to experience neuropsychiatric adverse effects remains difficult.”

We hope that research on therapeutic ketamine use continues, so that scientists may gain a better understanding of any individuals that may have a particular genetic susceptibility to side effects from ketamine use.

But how does a real ketamine patient describe their experience and its effects? We’ll feature a real user review in the next section of this article.

Unsponsored Ketamine Therapy Review

A YouTube video published on the popular Bustle channel documents an individual who undergoes ketamine therapy in a clinical setting to treat anxiety:

Our Mental Wellness Pick

Brightside Health is our top mental wellness support pick.

Brightside is an online therapy and medication platform that connects patients with licensed therapists and doctors from the comfort of their home.

medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.

Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both.

The brand reports that 86% of members feel significantly better within 12 weeks of treatment.

Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.

Stay up-to-date on our research reviews


Ketamine is a drug that can have powerfully therapeutic effects when administered properly, but its side effect profile is still relatively unknown (especially when considering long-term use).

Researchers have not yet been able to identify population subgroups that may be worse candidates for ketamine therapy in regard to psychiatric effects.

In regard to physical effects, patients with cardiovascular disease or high blood pressure may not be ideal ketamine therapy candidates, given that ketamine use can transiently increase stress on the cardiovascular system.

We hope that ketamine research continues, because this treatment modality is emerging as a potential alternative to prescription antidepressants that may significantly benefit some patients.