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Who May Not Be a Candidate for Ketamine Therapy

Honest exclusion is part of good care.

Written by: Ira ZootMedically reviewed by: Ketalux Clinical Review PanelLast updated: June 6, 2026Evidence: APA consensus 2017; FDA labeling
Quick answer
Who is generally not a candidate?
Common exclusions include uncontrolled hypertension or unstable cardiovascular disease, active psychosis, untreated bipolar disorder with manic features, recent stroke, severe liver disease, active substance use disorder, increased intracranial pressure, and pregnancy. Some are absolute; others are case-by-case.

Absolute or near-absolute exclusions

  • Uncontrolled hypertension
  • Unstable angina, recent MI, or severe heart failure
  • Active psychosis or schizophrenia (case-by-case)
  • Untreated bipolar disorder with manic features
  • Increased intracranial pressure or recent stroke
  • Severe liver disease
  • Active ketamine or dissociative substance use disorder

Relative considerations

  • Pregnancy (relative)
  • Severe untreated sleep apnea (case-by-case)
  • History of severe substance use disorder (case-by-case)
  • History of severe trauma without adequate support (case-by-case)

Related reading

Educational content only. Not medical advice. Discuss any treatment decisions with a qualified clinician.

About the author
Ira Zoot

Independent publisher and editor of Ketalux, based in Chicago, Illinois. Ira commissions, edits, and reviews every article on the site and believes ketamine therapy — used responsibly — offers real hope for people living with depression, anxiety, PTSD, and chronic pain. Contact: ira@idigits.com.

Educational use only. The content on this page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Ketamine and related therapies carry risks and are appropriate only under qualified medical supervision. Always consult a licensed healthcare professional about your individual situation. Information may change as research evolves.