Ketamine Therapy Side Effects
What to expect, honestly
Ketamine therapy has been used safely in medical settings for over 50 years. Here's what the research says and what our patients actually experience.
Common side effects
What most patients experience
Most side effects of ketamine therapy are mild and resolve on their own within an hour of your infusion ending. Here's what our patients report most often:
Nausea
About 1 in 3 patients feel some nausea during or shortly after the infusion. We pre-medicate with ondansetron (Zofran) when needed, and it typically resolves within 30-60 minutes.
Dizziness or lightheadedness
A mild floating or unsteady feeling is common. You'll be in a reclined position during your infusion and we'll have you take your time getting up.
Dissociation
Many patients feel 'detached' from their usual thoughts or surroundings — calm, dreamlike, or pleasantly dissociated. Most describe it as relaxing rather than alarming.
Elevated blood pressure
A temporary rise of 10-20% above your baseline is common during the infusion. We monitor continuously and can adjust or pre-medicate if your blood pressure tends to run high.
What to expect, hour by hour
Your infusion, from start to finish
0:00
Arrival and preparation
We review your meds, check your vitals, and settle you into your private room. If anxiety is an issue, we can start with a lower dose and adjust.
0:05
Infusion begins
You may feel a warm, floating sensation within 5-10 minutes. Many patients listen to music or close their eyes. You're awake and can speak with your provider at any time.
0:20-0:50
Peak effects
The peak dissociative window. Most patients find this deeply relaxing — some visualize colors or memories. Your provider is monitoring your heart rate, blood pressure, and oxygen throughout.
0:50-1:00
Recovery
The dissociative effects begin to fade. You'll rest for another 10-15 minutes as we monitor your vitals. Most patients feel clear-headed and calm by the end.
1:00-2:00
Going home
Your driver takes you home. You may feel quiet, introspective, or tired — this is normal. Most patients nap or rest quietly for the remainder of the day.
Rare but important
Side effects to know about
At the doses used for depression treatment, serious side effects are rare. But we believe in informed consent — here's what the evidence says:
Urinary issues
In rare cases (less than 1% at clinical doses), patients may experience bladder irritation or cystitis-like symptoms with frequent, long-term use. This has only been documented in high-dose recreational use, not at clinical treatment doses.
Dependence risk
Ketamine has abuse potential and can be habit-forming with unregulated use. At clinical doses given in a controlled medical setting, the risk of dependence is very low — but we screen for substance use history as part of your evaluation.
Blood pressure spikes
In very rare cases, blood pressure does not normalize after the infusion. We monitor for this. Patients with uncontrolled hypertension are typically not candidates for ketamine unless their blood pressure is stabilized first.
Contraindications
Who should not receive ketamine
Ketamine therapy is safe for most adults, but it's not right for everyone. You may not be a candidate if you have:
Medical contraindications
- Uncontrolled high blood pressure (hypertension)
- Active psychosis or schizophrenia
- Untreated hyperthyroidism
- Pregnancy or breastfeeding
- Severe liver disease
- Acute angle-closure glaucoma
Relative contraindications
- History of substance use disorder (we screen carefully)
- Bipolar disorder in a manic or hypomanic episode
- History of seizures (case-by-case basis)
- Certain heart conditions (reviewed individually)
- Concurrent use of certain medications
Red flags
When to contact your provider
Right away
- Severe chest pain
- Difficulty breathing
- Severe headache that doesn't resolve
- Signs of an allergic reaction
Next day
- Blood pressure above 180/110
- Persistent nausea or vomiting
- Worsening depression or suicidal thoughts
- Unusual agitation or confusion
Non-urgent
- Mild headache
- Fatigue or brain fog
- Vivid dreams
- Temporary emotional sensitivity
If you experience a medical emergency, call 911. For all other concerns, call us at (904) 877-1100. We check in with every patient after their first infusion.
Common questions
Ketamine side effect FAQs
What are the most common side effects of ketamine therapy?
The most common side effects are mild and temporary: nausea (about 1 in 3 patients), dizziness, a floating or dissociative feeling during treatment, and increased blood pressure. Most resolve within an hour of the infusion ending. We pre-medicate for nausea when needed.
Can ketamine therapy cause long-term side effects?
At the clinical doses used for depression (0.5 mg/kg administered 1-2 times per week), serious long-term side effects are rare. A 2023 Yale review found no evidence of organ damage at therapeutic doses. However, frequent high-dose recreational use has been associated with urinary issues — which is why medical supervision matters.
Will I feel 'out of it' during my ketamine infusion?
Most patients describe a calm, dreamlike, or floating sensation. You're awake and able to communicate but may feel detached from your surroundings. This dissociative state typically lasts 45-60 minutes and many patients find it therapeutic rather than unpleasant.
Can ketamine therapy increase my blood pressure?
Yes, temporarily. Ketamine typically causes a brief rise in blood pressure during the infusion (about 10-20% above baseline), which normalizes within an hour. We monitor your vitals continuously and can adjust your protocol or pre-medicate if needed.
Is it safe to drive after a ketamine infusion?
No. Your coordination and reaction time will be impaired for several hours after treatment. You must have someone drive you home. You should not drive or operate machinery until the next day.
Who should not receive ketamine therapy?
Ketamine is not recommended for: people with uncontrolled high blood pressure, active psychosis or schizophrenia, untreated hyperthyroidism, or a history of ketamine use disorder. Pregnant women should not receive ketamine. We'll review your full medical history during your consultation.
The ketamine resource center
Keep exploring ketamine therapy
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