Who Is Not a Good Candidate for Ketamine Therapy? How to Qualify

CEO, Co-founder and Partner
Cheryl has been working in the private Mental Health and Addiction treatment world for 30 years, as a clinician, clinical director, program founder, program administrator, and facility decorator!

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Who Is Not a Good Candidate for Ketamine Therapy? How to Qualify

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Ketamine Therapy: An Overview of Its Potential

Ketamine therapy has emerged as a groundbreaking treatment in mental health, particularly gaining acclaim for its rapid action and effectiveness in cases where traditional treatments have failed. Initially developed and approved as an anesthetic, ketamine’s use has expanded significantly, offering new hope to individuals grappling with severe mental health disorders.

The uniqueness of ketamine therapy lies in its mechanism of action, which differs significantly from conventional antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIss). 

While most SSRIs take 2-4 weeks to exert their effects by gradually altering neurotransmitter levels, ketamine works almost instantaneously, affecting the brain’s NMDA receptors and releasing a cascade of changes that can rapidly improve mood. This swift response is particularly crucial for individuals with Treatment Resistant Depression, major clinical depression or those experiencing suicidal ideation, providing relief when time is of the essence.

Beyond depression, ketamine has shown potential in treating a range of conditions, including severe anxiety, post-traumatic stress disorder (PTSD), and certain chronic pain syndromes. Its ability to promote neuroplasticity–the brain’s capacity to form new neural connections–offers a plausible explanation for its effectiveness. This neuroplastic effect can lead to lasting changes in brain function, potentially resetting maladaptive neural pathways associated with mood disorders.

However, ketamine therapy isn’t a one-size-fits-all solution. Its rapid effects can be a double-edged sword, necessitating a controlled clinical setting to manage administration, and potential side effects as well as ensure patient safety. The therapy involves a series of injections, infusions or nasal spray administrations under medical supervision, with the dosage and frequency tailored to each individual’s needs.

While the potential of ketamine therapy is immense, it’s important to approach it with a nuanced understanding. Ketamine represents a significant advancement in mental health treatment, offering a lifeline for those who have not benefited from traditional therapies. Yet, its administration requires careful assessment and consideration, emphasizing the need for comprehensive evaluation and monitoring to harness its benefits safely and effectively.

In essence, ketamine therapy is finally seen as a promising treatment in mental health, offering rapid relief and a new perspective on treatment-resistant conditions. Its expanding use underscores a broader movement towards innovative, evidence-based approaches in psychiatric care, promising a brighter future for those battling debilitating mental health disorders.

Factors to Consider for Ketamine Candidates

When considering candidates for ketamine therapy, healthcare providers evaluate a range of factors to ensure the treatment is appropriate and safe for the individual. Here’s a list of key factors that are typically considered:

  • Diagnosis and Severity of Condition: Ketamine therapy is often considered for individuals with severe, treatment-resistant depression, certain anxiety disorders, PTSD, and some chronic pain conditions. The severity and nature of the condition are critical in determining candidacy.
  • Treatment History: Patients who have not responded to conventional treatments, including multiple antidepressants and psychotherapy, may be considered for ketamine therapy. A detailed treatment history helps assess whether ketamine is a suitable next step.
  • Physical Health: A comprehensive physical examination and medical history are essential to identify any underlying health conditions that might contraindicate ketamine use, such as uncontrolled hypertension, cardiovascular disease, or a history of substance misuse.
  • Psychiatric History: Understanding a patient’s psychiatric history, including any instances of psychosis or bipolar disorder, is crucial since ketamine may not be suitable for individuals with certain psychiatric conditions.
  • Substance Use History: A thorough evaluation of the patient’s history with substance use is vital, as ketamine has potential for misuse. Patients with a history of substance abuse may need to be evaluated more cautiously.
  • Risk of Side Effects: The potential for side effects, including dissociation, elevated blood pressure, and in rare cases, bladder issues, should be considered and discussed with the patient.
  • Safety and Monitoring: Ensuring that the patient understands the need for monitoring during and after ketamine administration is crucial for safety and the effectiveness of the therapy.
  • Support System: The patient’s support system and their ability to follow through with the treatment plan, including getting to and from sessions safely, is an important consideration.
  • Informed Consent: The patient must be able to provide informed consent, understanding the potential benefits and risks of ketamine therapy.
  • Mental State and Expectations: Assessing the patient’s mental state and ensuring they have realistic expectations about the outcomes of ketamine therapy are important for overall treatment success.
  • Comorbid Conditions: Evaluating other mental or physical health conditions is crucial as they may affect the suitability or administration of ketamine therapy.

By carefully considering these factors, healthcare providers can better determine who might benefit most from ketamine therapy, ensuring that it is used safely and effectively in the management of complex and treatment-resistant conditions.

Who Is Not a Good Candidate for Ketamine Therapy?

Ketamine therapy, particularly for mental health conditions, has gained attention in recent years as an innovative treatment option. However, it’s not suitable for everyone, and the decision to use ketamine therapy should always be guided by a healthcare professional. Here are some general considerations to determine who might be a good candidate for ketamine therapy:

  • Treatment-Resistant Depression: Patients who have not responded to conventional antidepressants or other treatments for depression might benefit from ketamine. It’s particularly considered for those with severe, treatment-resistant depression.
  • Acute Suicidal Ideation: Because of its rapid-acting nature, ketamine has been studied in the context of reducing acute suicidal thoughts in individuals with mood disorders.
  • Other Mood Disorders: Besides depression, ketamine might be beneficial for individuals with certain other mood disorders, such as anxiety or bipolar disorder, especially if other treatments have not been effective.
  • Chronic Pain Syndromes: Ketamine is sometimes used for chronic pain management, particularly for conditions where pain is difficult to control with standard treatments.
  • Proper Medical Supervision: A good candidate is someone who can undergo ketamine therapy under the guidance and supervision of a qualified healthcare provider, ensuring that the treatment is administered safely and effectively.
  • No Contraindicating Health Conditions: Patients should not have health conditions that could make ketamine dangerous for them. For instance, individuals with certain cardiovascular conditions, uncontrolled hypertension, or a history of substance abuse may not be suitable candidates.
  • Informed Consent: A good candidate is someone who has been fully informed about the potential benefits and risks of ketamine therapy and agrees to proceed with a clear understanding of the treatment process.

It’s crucial for anyone considering ketamine therapy to have a thorough evaluation by a healthcare provider to discuss their medical history, mental health history, and other treatment options before deciding on ketamine therapy. This ensures that the treatment is appropriate for their specific condition and circumstances.

Who Is a Good Candidate for Ketamine Therapy?

Ketamine therapy, recognized for its potential to rapidly alleviate symptoms of certain mental health and chronic pain conditions, is particularly suited for specific patient profiles. Identifying ideal candidates ensures the therapy is both effective and safe. Here are characteristics of individuals who might be considered good candidates for ketamine therapy:

Treatment-Resistant Depression: Individuals who have not responded adequately to traditional antidepressants and psychotherapy might benefit significantly from ketamine. Its rapid action can offer relief when other treatments have failed.

Severe, Acute Depression: Patients experiencing intense, acute episodes of depression, especially with suicidal ideation, where the urgency for symptom relief is critical, may be suitable for ketamine therapy due to its rapid onset of action.

Chronic Pain Conditions: Ketamine has shown promise in treating certain chronic pain conditions that have not responded well to other treatments, such as neuropathic pain and complex regional pain syndrome.

Certain Anxiety Disorders: People with anxiety disorders, including generalized anxiety disorder or PTSD, who have not found relief with standard treatments, may benefit from ketamine therapy.

Obsessive-Compulsive Disorder (OCD): Individuals with OCD who haven’t adequately benefited from conventional treatments may be good candidates for ketamine therapy.

Adequate Physical Health: Candidates should be in reasonably good physical health without uncontrolled hypertension or significant heart disease, as ketamine can increase blood pressure and heart rate.

Informed and Compliant: Good candidates are those who can understand the nature of the treatment, consent to undergo therapy, and comply with the treatment regimen and follow-up appointments.

Support System: Having a reliable support system is beneficial for those undergoing ketamine therapy, as it can assist with transportation and emotional support.

Monitoring and Adjustment: Candidates should be open to ongoing monitoring and adjustment of their treatment plan, working closely with their healthcare provider to optimize outcomes.

Exclusion of Contraindications: Ideal candidates do not have contraindications to ketamine therapy, such as a history of substance abuse or certain psychiatric conditions that could be exacerbated by ketamine.

By thoroughly evaluating individuals against these criteria, healthcare providers can identify those who are likely to benefit most from ketamine therapy, ensuring that the treatment is administered safely and effectively to those most likely to see significant improvements in their conditions.

How To Qualify for Ketamine Infusions

Qualifying for ketamine infusions involves a series of steps designed to ensure that this treatment is appropriate and safe for the individual. Here’s a general guide on how one might qualify for ketamine infusions:

1. Initial Consultation and Assessment

  • Consult a Healthcare Provider: The first step is to consult with a healthcare provider who is experienced in administering ketamine therapy. This is often a psychiatrist, anesthesiologist, or a pain specialist.
  • Medical and Psychiatric Evaluation: A thorough evaluation is necessary to understand your medical history, current health status, and psychiatric background. This includes discussing your symptoms, previous treatments, and any medications you’re currently taking.

2. Diagnostic Criteria

  • Confirm Diagnosis: Ketamine is typically used for conditions like treatment-resistant depression, certain anxiety disorders, chronic pain, and PTSD. Your doctor will confirm that your diagnosis aligns with the conditions ketamine is known to potentially benefit.
  • Treatment History: You’ll need to provide a detailed history of your treatment, including medications and therapies you’ve tried, to demonstrate that standard treatments have not been effective.

3. Physical Health Screening

  • Physical Examination: A physical examination is crucial to ensure there are no health issues that could be contraindications for ketamine therapy.
  • Lab Tests: Blood work and other tests may be necessary to check your overall health status and ensure there are no underlying conditions that could affect the treatment’s safety or effectiveness.

4. Mental Health Considerations

  • Psychiatric Assessment: Mental health stability is essential. Conditions like untreated psychosis or severe bipolar disorder might be contraindications.
  • Informed Consent: It’s vital that you understand the potential benefits, risks, and side effects of ketamine therapy. You’ll be required to give informed consent.

5. Treatment Planning

  • Developing a Treatment Plan: If you qualify, your healthcare provider will develop a personalized ketamine infusion plan, including the dosage, number of sessions, and monitoring protocols.
  • Monitoring and Support: Discuss how your response to the treatment will be monitored and what kind of support and follow-up care will be available.

6. Financial and Insurance Considerations

  • Cost and Coverage: Understand the costs involved and check with your insurance provider about coverage, as ketamine infusions for mental health conditions are often not covered by insurance.

7. Safety and Emergency Protocols

  • Emergency Plan: Ensure that there is a plan in place for dealing with any potential adverse reactions during the infusion.

8. Ongoing Assessment

  • Response Evaluation: Continuous assessment of your response to the treatment is crucial for determining the effectiveness and deciding on the future course of ketamine therapy.

By following these steps and working closely with a healthcare provider, individuals can determine if ketamine infusions are a suitable option for their specific conditions and circumstances.

Ketamine Therapy FAQs

Do You Need a Prescription for ketamine therapy?

  • Yes, you need a prescription for ketamine therapy. Ketamine is a controlled substance and must be administered by a healthcare professional in a clinical setting. Patients cannot obtain ketamine for therapeutic use without a prescription. The prescription and administration are typically overseen by a psychiatrist, anesthesiologist, or other medical professionals trained in ketamine therapy.

How Old Do You Have To Be for Ketamine Therapy?

  • The age requirement for ketamine therapy can vary, but generally, it is more commonly prescribed to adults. Some clinics and practitioners may offer ketamine therapy to adolescents, particularly in cases of severe, treatment-resistant depression or other psychiatric conditions, but this is done under strict medical supervision and with parental consent. The safety and efficacy of ketamine therapy in children and adolescents are less well-studied, so healthcare providers proceed with caution in younger populations.

How Much Is Ketamine Therapy?

The cost of ketamine therapy can vary widely based on several factors including the treatment format (infusion, nasal spray, etc.), the provider’s qualifications, and the geographic location of the clinic. Here are some general guidelines:

Ketamine Infusions: This is the most common form of ketamine therapy used primarily for depression and certain chronic pain conditions. Typically, each infusion can cost between $400 to $800. Most treatment protocols recommend a series of 6-8 infusions over a few weeks, so the total cost can range from $2,400 to $6,400.

Esketamine (Spravato) Nasal Spray: This is a nasal spray form of ketamine approved specifically for treatment-resistant depression, often in conjunction with an oral antidepressant. The costs here can also be quite high, depending on insurance coverage. Without insurance, the therapy can cost several hundred dollars per session, and it usually requires multiple sessions over several weeks.

Insurance Coverage: Insurance coverage for ketamine treatments varies. Traditional ketamine infusions are often not covered by insurance as they are not FDA-approved for depression, but esketamine (Spravato) is more likely to be covered since it has FDA approval.

Additional Costs: Beyond the medication itself, costs can include initial consultation fees, monitoring during treatment, and follow-up appointments. These can add significantly to the overall expense.

If you’re considering ketamine therapy, it’s best to consult with a few clinics to get detailed pricing and to check with your insurance provider to see what, if any, aspects of treatment might be covered.

Corner Canyon Can Help With Ketamine-Assisted Psychotherapy

At Corner Canyon Health Centers, if a client is clinically and medically approved, we offer a 6 week course of ketamine shots, administered intramuscularly in a quiet private room and supervised by medical personnel. This is followed by a therapy session with the primary therapist. Subsequent group and individual therapy sessions throughout the week also capitalize on the increased neuroplasticity of the brain to achieve greater therapeutic gains than possible otherwise.

If you or a loved one would like to participate in this closely supervised treatment, reach out to us to discuss or book an appointment.

CEO, Co-founder and Partner
Cheryl has been working in the private Mental Health and Addiction treatment world for 30 years, as a clinician, clinical director, program founder, program administrator, and facility decorator!

Liz Lund, MPA

Liz is originally from lush green Washington State. She is a life enthusiast and a huge fan of people. Liz has always loved learning why people are the way they are. She moved to UT in 2013 and completed her bachelors degree in Psychology in 2016. After college Liz worked at a residential treatment center and found that she was not only passionate about people, but also administration. Liz is recently finished her MPA in April 2022. Liz loves serving people and is excited and looking forward to learning about; and from our clients here at Corner Canyon.
When Liz is not busy working she love being outdoors, eating ice cream, taking naps, and spending time with her precious baby girl and sweet husband.