Patient Safety

Ketamine Safety Information

Understand possible risks, follow your individualized instructions, and know when and how to seek help.

Possible risks and adverse effects
Dissociation and perception changes
Patients may experience detachment, altered awareness, dizziness, or changes in perception.
Misuse, dependence, and tolerance
Ketamine is a Schedule III controlled substance and must be used only as prescribed.
Respiratory complications
Breathing problems are uncommon but can be serious, particularly with excessive dosing or interacting substances.
Sedation and drowsiness
Reduced alertness may continue after the immediate effects seem to resolve.
Psychological effects
Anxiety, agitation, confusion, distressing dreams, hallucinations, or other reactions may occur.
Blood pressure and heart rate changes
Ketamine may increase or otherwise affect blood pressure and heart rate.
Nausea and vomiting
Symptoms may occur during or after treatment.
Urinary, liver, and cognitive complications
Repeated high-dose exposure or misuse has been associated with bladder, liver, memory, and attention problems.
Tell your physician before treatment
Provide complete and accurate information, including:

All prescription medications, over-the-counter drugs, vitamins, and supplements

Pregnancy, plans for pregnancy, or breastfeeding

Alcohol, cannabis, opioid, sedative, stimulant, or other substance use

History of psychosis, mania, severe agitation, substance misuse, or ketamine misuse

Heart disease, uncontrolled blood pressure, breathing problems, or prior anesthesia complications

Liver, kidney, urinary, bladder, or other significant medical conditions

Do not stop or change prescribed medication unless instructed by the treating clinician.
Safety requirements by program
IV Ketamine at Klearmind
Continuous clinical monitoring begins after IV placement and continues throughout the infusion until IV removal. Additional recovery and discharge assessment are completed before leaving.
  • Arrange for a responsible adult to drive you home.
  • Do not drive or operate machinery for at least 24 hours.
Oral KAP at a Therapist’s Office
Six planned oral ketamine sessions take place at an independent therapist’s office. Therapist services are separate from Klearmind medical care.
  • Follow physician and pharmacy instructions.
  • Arrange for a sober, responsible adult to take you home.
  • Do not drive for at least 24 hours.
At-Home Oral Ketamine
  • A sober, responsible adult must remain with you for the entire session.
  • Use only the prescribed dose in the planned setting. Never share medication or take an additional dose unless specifically instructed.
  • Keep a phone accessible and follow the individualized safety plan.
  • Do not drive for at least 24 hours.
Before and after every treatment
Follow your instructions
Follow your individualized fasting, hydration, and medication instructions.
Avoid interacting substances
Do not combine ketamine with alcohol, cannabis, sedatives, opioids, or other substances unless specifically cleared by your physician.
Avoid driving and important decisions
Do not drive, operate machinery, sign important documents, or make important decisions for at least 24 hours.
Report changes
Report adverse effects, medication changes, or changes in your physical or mental health before the next treatment.

Know when to seek immediate help

Call 911 for trouble breathing, chest pain, loss of consciousness, seizure, severe confusion or agitation, serious injury, or another medical emergency.

For a mental health or suicide crisis, call or text 988.

Klearmind clinical support

Secure-text clinical support is available from 6:00 a.m. to 8:00 p.m. Pacific Time. Klearmind does not provide 24-hour or on-call emergency services.

FDA status and compounded oral ketamine

Ketamine hydrochloride injection is FDA-approved for use as a general anesthetic. Its use for psychiatric conditions and chronic pain is off-label. Ketamine is not FDA-approved to treat any psychiatric disorder.

Compounded oral ketamine is not FDA-approved. The FDA does not review compounded medications for safety, effectiveness, or quality before they are marketed. Klearmind prescribes but does not compound or dispense oral ketamine. When prescribed, medication is prepared and dispensed by an appropriately licensed compounding pharmacy pursuant to a valid, patient-specific prescription.

Do not include medical information in ordinary email.

Important Medical Information: Klearmind provides physician-directed medical services to eligible patients located in California. Ketamine is FDA-approved as an anesthetic. Its use for psychiatric and pain conditions is off-label. IV ketamine is administered at the Klearmind clinic under medical supervision. Oral ketamine-assisted psychotherapy sessions take place at participating therapists’ offices. Eligible patients in the at-home oral ketamine program complete sessions according to an individualized physician-directed treatment plan. Compounded oral ketamine is not FDA-approved. Klearmind prescribes but does not compound or dispense oral ketamine. When prescribed, medication is prepared and dispensed by an appropriately licensed compounding pharmacy pursuant to a valid, patient-specific prescription and sent to the patient’s verified California address. Other compounded medications, including compounded peptides and compounded GLP-1 medications, are not FDA-approved. The FDA does not review compounded medications for safety, effectiveness, or quality before they are marketed. Treatment eligibility, prescribing decisions, and treatment recommendations are determined individually by the treating physician. Individual experiences and responses vary. No particular outcome is guaranteed. Secure-text clinical support is available from 6:00 a.m. to 8:00 p.m. Pacific Time. Klearmind does not provide 24-hour or on-call emergency services. Call 911 for a medical emergency or call or text 988 during a psychiatric crisis.

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