Ketamine therapy administered by a professional is safe, but it can cause short-term effects like dissociation, nausea, or dizziness.
What to know:
- Clinics closely monitor patients during esketamine (Spravato) and IV ketamine sessions.
- Most side effects resolve within hours, but professional oversight is critical for safety.
- Clinic staff will screen you for preexisting conditions that can affect side effects or treatment eligibility.
For those with treatment-resistant depression, ketamine therapy can offer hope. FDA-approved esketamine nasal spray and off-label IV ketamine infusions both show fast positive effects. That said, they also carry potential side effects that clinics carefully track.
Not everyone experiences side effects from ketamine therapy. And for those who do, the benefits of ketamine therapy often outweigh the downsides. Below, we’ll cover a few common side effects of ketamine therapy to help you understand the risks.
1. Dissociation or Perceptual Changes
Dissociation is one of the most recognized side effects of ketamine therapy. Patients sometimes report feeling detached from their body, having an altered perception of time, or experiencing mild hallucinations. These effects can be related to the ketamine dose, and they usually resolve within a couple of hours under clinic supervision.
In some clinical research, esketamine treatment produced measurable perceptual changes in a subset of patients. This response is part of ketamine’s interaction with NMDA receptors in the brain, which also underpins its antidepressant properties. (Note that ketamine is not an opioid, though its effects have some superficial similarities.)
Patients reported changes in audio perception or proprioception (the body’s sense of its position in space). Other patients reported more mystical effects, like feeling a unitive sensation or that they transcended the ordinary world.
2. Dizziness or Lightheadedness
Another common short-term reaction is dizziness. Intravenous infusions and intranasal administration can both trigger a temporary imbalance in blood flow and oxygen delivery, which can make you feel a bit lightheaded.
Dizziness can persist for a short time post-session. This is one reason we advise patients not to drive immediately after treatment. If you get treatment at a clinic, nurses and board-certified psychiatrists will monitor your recovery.
3. Nausea and Vomiting
Some patients experience nausea during or after ketamine infusion therapy. Ketamine causes your central nervous system to change quickly, and that can cause your vestibular system (balance) and gastrointestinal tract to “cross wires.”
It’s similar to how people in a moving vehicle without seeing the outside can get sick, since their vision and balance systems are sending different signals. If you get motion sickness easily, you might be more prone to this side effect from ketamine therapy.
4. Increased Blood Pressure
Ketamine can cause a temporary rise in blood pressure and heart rate since blocking NMDA receptors also releases the brakes on your sympathetic nervous system (SNS). This system is your fight-or-flight response, so your vitals can increase during treatment. This effect is usually mild in healthy adults but may require extra monitoring in patients with cardiovascular risk factors.
If you have untreated high blood pressure, the clinic might recommend you postpone ketamine therapy for now. Either way, clinics track your vital signs before, during, and after treatment to manage potential complications.
Because ketamine is an anesthetic, you won’t feel physically energized. You can feel like you’re floating along with a calmness or heaviness instead. Your body will just have a higher heart rate and blood pressure for a while.
5. Sedation or Drowsiness
While the goal with ketamine for depression isn’t to anesthetize, you can feel sedated or drowsy. You might feel extremely relaxed or fatigued, and some patients need several hours before returning to normal activity after treatment.
This is another reason that treatment guidelines recommend patients arrange transportation after a session. Sedation only lasts temporarily, but it requires clinic oversight for safety.
6. Headache
Some patients get headaches after ketamine treatment, which is likely related to vascular changes and NMDA receptor effects. Headaches are usually mild, but they can last into the following day.
Clinics may recommend you stay hydrated or take a pain reliever if needed for longer symptoms. In most cases, headaches don’t interfere with the overall antidepressant effect of ketamine treatment.
7. Blurred Vision or Double Vision
Visual changes like blurriness or diplopia (double vision) are temporary but also reported in ketamine studies. Some of the brain structures that ketamine affects are responsible for coordinating the tiny eye muscles, which is why this can happen.
This side effect should be resolved once your body processes the ketamine, but it’s another reason to stay out of the driver’s seat or off heavy machinery after a session.
How Clinics Help Manage Ketamine Side Effects
Ketamine clinicians like ours at Modern Behavioral follow strict safety protocols to reduce risks and keep patients as comfortable as possible. Board-certified psychiatrists or trained psychiatric nurse practitioners (PMHNP-BC) monitor blood pressure, oxygen levels, and patient response throughout the session.
Other protocols to manage side effects may include pre-screening for cardiovascular conditions, anti-nausea medication, and extended observation time. While ketamine therapy for depression can have side effects, our goal is to keep them minimal and manageable so you can get the most out of treatment.
Bottom Line: Ketamine Side Effects Are Manageable
In the big picture, getting relief for treatment-resistant depression can far outweigh the temporary side effects of ketamine for depression. While side effects like dissociation, nausea, or dizziness are common, they are typically short-lived and manageable under professional care.
Clinical oversight is key to balancing safety with therapeutic outcomes. If you’re looking for ketamine therapy in Pennsylvania, Modern Behavioral is here to help. Reach out today to speak with licensed professionals about personalized ketamine treatment.
FAQs on Ketamine Side Effects
Below are a few frequently asked questions about ketamine side effects.
Does every patient experience dissociation?
Not every patient receiving ketamine for depression experiences dissociation. It’s a common side effect, but not guaranteed to happen.
How long do side effects last?
Most ketamine side effects resolve within a few hours after treatment, which is why it’s recommended that you arrange transportation from the clinic and avoid driving after a session.
Is nausea preventable during ketamine infusion?
Nausea can be prevented depending on the patient, and many clinics prescribe anti-nausea medication beforehand to reduce symptoms.
Can ketamine raise blood pressure dangerously high?
While ketamine treatment can increase blood pressure, clinics monitor patients and intervene if needed. This is why it’s important to let your provider know about any health issues you may have.
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