Medical Disclaimers

Important Treatment Information

Ketamine is approved by the FDA as an anesthetic. The FDA has not approved ketamine for the treatment of depression, anxiety, PTSD, OCD, insomnia, chronic stress, or any other psychiatric condition. When a licensed healthcare provider prescribes ketamine for these conditions, it is prescribed off label.

Compounded ketamine products are not FDA approved. The FDA does not review compounded medications for safety, effectiveness, or quality before they are marketed in the same way it reviews FDA approved drugs.

Esketamine (Spravato) is a separate, FDA approved medication for treatment resistant depression. It is a different product, administered under supervision in a certified healthcare setting. Kalm does not provide esketamine, and approvals granted to esketamine do not apply to the medication prescribed through Kalm.

Ketamine is a Schedule III controlled substance under federal law.

Treatment is available only when prescribed by a licensed healthcare provider following an appropriate medical evaluation. Prescription treatment is not guaranteed.

Ketamine is not appropriate for everyone

Your healthcare provider will review your health history, current medications, potential contraindications, and individual risk factors before determining whether treatment is appropriate for you. Some people are not candidates for treatment, and some people do not respond to it.

Risks

Cardiovascular

Ketamine can cause temporary increases in blood pressure and heart rate. This can be dangerous for people with uncontrolled high blood pressure, a history of aneurysm, significant coronary or cerebrovascular disease, or a recent cardiac event. Tell your provider about any heart or blood pressure condition.

Psychiatric

Ketamine can precipitate or worsen psychosis. People with a history of psychotic disorders may be at risk. In people with bipolar disorder, ketamine may contribute to manic or hypomanic symptoms.

Dissociation and perceptual effects

Ketamine can cause dissociation, altered perception of time, space and body, vivid dreams, and in some cases hallucinations. These effects can be unpredictable, and for some people they are distressing or frightening. Lower doses are intended to reduce the likelihood and intensity of these effects, but they do not eliminate the possibility.

Misuse and dependence

Ketamine has potential for misuse and dependence. This risk is higher when it is used outside a medical setting, at higher doses than prescribed, or more frequently than prescribed. Take your medication only as prescribed. Do not share it with anyone. Tell your provider about any history of substance use disorder.

Bladder and urinary tract

Long term or heavy ketamine use has been associated with bladder and urinary tract damage, including a condition known as ketamine induced cystitis or uropathy. Tell your provider promptly if you experience urinary urgency, increased frequency, pain when urinating, or blood in your urine.

Cognitive effects

Chronic and heavy ketamine use has been associated with memory and cognitive difficulties.

Long term use

The long term effects of regular or daily ketamine use are not fully understood. Research is ongoing.

Liver

Elevated liver enzymes have been reported with repeated or higher dose ketamine use. Tell your provider about any liver condition.

Pregnancy and breastfeeding

Ketamine is not recommended during pregnancy or while breastfeeding. There is insufficient safety data. Tell your provider if you are pregnant, may become pregnant, are trying to conceive, or are breastfeeding.

Commonly reported side effects

Nausea, dizziness or lightheadedness, drowsiness, headache, changes in perception, vivid dreams, fatigue, blurred vision, anxiety, and temporary increases in blood pressure.

Side effects vary from person to person. Some people experience none. Contact your provider if side effects are severe, persistent, or concerning to you.

While in treatment

• Do not drive or operate machinery after dosing. Follow the specific timeframe your provider gives you.
• Do not combine ketamine with alcohol, benzodiazepines, opioids, or other sedatives unless your provider has told you it is safe.
• Follow all individualised instructions from your provider on medication use, monitoring, activities, and follow up care.
• Do not increase your dose or dosing frequency on your own.
• Do not stop other prescribed medications without speaking to the prescriber.
• Report side effects, new symptoms, or changes in your mental health to your provider.

Medication interactions

Your provider will review your full medication list and assess potential interactions before determining whether treatment is appropriate. Tell your provider about all prescription medications, over the counter medicines, supplements, and recreational substances you use.

If you are in crisis

If you are in a life threatening situation, do not use this site.

• Call 911
• Call or text 988, the Suicide and Crisis Lifeline
• Text HOME to 741741, the Crisis Text Line

Kalm does not provide emergency or crisis services.

No guarantee of results

Responses to treatment vary from person to person, and some people do not respond. Kalm does not guarantee any particular result, timeline, or outcome. Any patient experiences described elsewhere on this site are individual and do not predict your results.

Questions

Discuss any medical question, risk, interaction or contraindication with your healthcare provider. This page is general information and is not medical advice.