But beyond depression? “We know very little,” he says. Some studies suggest ketamine therapy (the IV form) may also be useful for bipolar disorder, PTSD, OCD, and even Parkinson’s disease—but the research has been mixed. “It’s still quite experimental when used for these other conditions,” says Dr. Sanacora.
That’s not to say the infusions, sprays, and tablets can’t be effective for other mental health conditions or even concerns like marital troubles—we just don’t have enough data to fully understand if and how it works or what the effects might be, according to Dr. Sanacora. (His best guess is that the evidence will ultimately show the drug does benefit some of these conditions like PTSD.) But Dr. Ni’s current take? “More research is needed before we start using it for all those things.”
That said, if there’s one consistency Dr. Sanacora’s noticed, it’s that people’s expectations play a big role in how well the treatment works. If you expect to feel better, there’s a better chance you will, he says.
Is ketamine therapy right for you?
You’re probably used to us reminding you that you should always talk to a doctor you trust whenever considering new treatment, but when it comes to ketamine therapy, this piece of advice should not be overlooked. In the right person, the drug can, as Dr. Sanacora says, be life-saving. But it can also be dangerous when given to the wrong person. “There are some pretty significant risks,” says Dr. Ni—which is why the medical community largely agrees it should be set aside for severe cases of depression, not mild to moderate ones.
What are said risks? First, ketamine can raise your blood pressure and heart rate so if you have a history of stroke, heart attack, or cardiovascular issues, you should avoid it. That said, blood pressure can even skyrocket in people without these risk factors, says Dr. Ni, creating a medical emergency (this is why she believes at-home lozenges and preloaded, self-administered syringes are just too risky).
Ketamine can also impair cognition, perceptions, and decision-making, and in some, trigger psychosis (so it’s often a no-go in those with a history of schizophrenia or related conditions). And because the drug may impact the health of the fetus, pregnant people should hold off. There’s also the potential for addiction, adds Dr. Ni (which is considered moderate to low as a Schedule III substance). Plus, some evidence—much of which, it’s worth noting, was gathered on recreational use, not medical—suggests long-term ketamine use may impair brain function, injure the liver, and damage the bladder.
Lastly, consider the commitment. While some people may only need one infusion every couple of months or even years to reap the benefits they’re after, others have to keep up with weekly sessions before tapering down to biweekly or monthly treatments. Dr. Ni suggests asking yourself if you’re willing and able to carve out the time (and money) to regularly visit a doctor to sustain the benefits.
How to be smart—and safe!—if you’re interested in ketamine
As SELF previously reported, a good place to start is the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3) directory, as members of this organization pledge to uphold standards of practice and ethical principles when providing health care services.
