Ketamine treatment may be a welcomed option for patients who\u2019ve struggled with finding effective relief for various mental health conditions. <\/p>\n
For those choosing ketamine treatment while also using other psychiatric medicines, a common question arises: Is it safe to combine ketamine treatment with anxiety or depression medications, amongst others? <\/p>\n
There are a number of things to consider when it comes to concurrent use of ketamine therapy and other pharmaceutical medications. Dr. Leonard Vando, a New York-based board certified psychiatrist and the Medical Director at Mindbloom, helps break it down. <\/p>\n
Selective serotonin reuptake inhibitors (SSRI) are a common class of drugs that are typically used as antidepressants to treat conditions like major depressive disorder and anxiety disorders. Some brands of SSRIs include: Sertraline (Zoloft), Fluoxetine (Prozac), Escitalopram (Lexapro), Citalopram (Celexa), and Paroxetine (Paxil, Pexeva).<\/p>\n
When it comes to combining SSRIs and ketamine treatment, the good news is that it\u2019s considered to be safe.<\/p>\n<\/p>\n
\u201cKetamine works with the NMDA receptors, the glutamate receptor,\u201d says Dr. Vando. \u201cYou can use it in addition to most SSRIs, and almost every antidepressant on the market. As a blanket statement, that\u2019s the truth.\u201d<\/p>\n
Serotonin\u2013norepinephrine reuptake inhibitors (SNRIs) are a category of antidepressant drugs used to treat a host of conditions like: major depressive disorder, anxiety disorders, obsessive compulsive disorder, social phobia, attention-deficit hyperactivity disorder, chronic neuropathic pain, fibromyalgia syndrome, and menopausal symptoms.<\/p>\n
Brands of SNRIs include: Venlafaxine (Effexor XR), Duloxetine (Cymbalta), Desvenlafaxine (Pristiq), and Levomilnacipran (Fetzima). For the most part, SNRIs are safe to take during ketamine treatment. <\/p>\n
However, some SNRIs tend to increase blood pressure in some patients, though it\u2019s usually minimal and self limiting. Blood pressure and heart rate increases for many during ketamine treatment. Dr. Vando notes that\u2019s why blood pressure is monitored before and after each session. <\/p>\n
\u201cIf the blood pressure is too high, treatment won\u2019t be administered,\u201d he says. <\/p>\n
Monoamine oxidase inhibitors (MAOI) are a class of antidepressants first introduced in the 1950s, which are also used to treat panic disorder and social phobia. <\/p>\n
MAOIs are less commonly used compared to other classes of antidepressants, as they have a host of side effects. Patients on MAOIs often have a team of professionals to help administer the treatment, as well as a special diet they must follow. MAOI are often prescribed as a last resort, as they are shown to be highly effective. <\/p>\n
Some brands of MAOI include: isocarboxazid (Marplan), tranylcypromine (Parnate), rasagiline (Azilect), phenelzine (Nardil), and selegiline (Eldepryl, Zelapar).<\/p>\n
Dr. Vando says he has not heard of any adverse effects from ketamine treatment and patients who are on MAOI. However, they should proceed carefully with the treatment.<\/p>\n<\/p>\n
\u201cAnyone using ketamine therapy while on MAOIs has to do it with caution, and only if the benefits clearly outweigh the risk,\u201d he says. <\/p>\n<\/p>\n
Wellbutrin is the brand name for Bupropion, which is an antidepressant mostly used to treat major depressive disorder (MDD), seasonal affective disorder (SAD), and to support smoking cessation. It\u2019s also used as an off-label treatment for Attention Deficit Hyperactivity Disorder (ADHD).<\/p>\n
Medications used to treat ADHD directly include: Adderall (amphetamine), Ritalin (methylphenidate), Concerta (methylphenidate), Dexedrine (amphetamine), Evekeo (amphetamine), Focalin XR (dexmethylphenidate), Quillivant XR (methylphenidate), and Strattera (atomoxetine hydrochloride).<\/p>\n<\/p>\n
Dr. Vando says this category of medication should be closely monitored while ketamine therapy is being administered.<\/p>\n<\/p>\n
\u201cBlood pressure may be mildly elevated upon initiation of treatment, and while monitoring it is not routinely done for patients receiving these medications, it is worth noting that ketamine also may mildly increase blood pressure,\u201d he explains. \u201cThis does not necessarily mean an added burden, as blood pressure monitoring is routinely done when receiving ketamine. So it really confers no additional risk.\u201d<\/p>\n<\/p>\n
Many patients who resort to ketamine therapy do so because traditional psychiatric medication doesn\u2019t seem to be enough. <\/p>\n<\/p>\n
While ketamine can be used in combination with almost every antidepressant on the market, that\u2019s not the case for all forms of psychedelic therapy. <\/p>\n
That\u2019s because other psychedelics work on similar pathways as antidepressants medications – like serotonin. Dr. Vando explains that if a patient decides to try ayahuasca, psilocybin, or DMT, it shouldn\u2019t be mixed with their medication and they should consider getting off with the help of a professional. <\/p>\n<\/p>\n<\/p>\n
Doing so without professional guidance may not be a good idea, and in some cases may cause more harm and risk in the long run.<\/p>\n<\/p>\n
\u201cWhile alternative therapeutic treatment is known to help with depression and anxiety, most people who deal with depression and anxiety are on some type of antidepressant, so that\u2019s an obstacle.\u201d<\/p>\n<\/p>\n
It\u2019s crucial to be upfront with your care team about your history of prescribed medications, as well as any illegal drug use, as it helps the care team make an informed decision for your overall health and safety.<\/p>\n
\u201cIt\u2019s good to reveal what you\u2019re on to the person you\u2019re working with,\u201d says Dr. Vando. <\/p>\n
Some medications that are prescribed, like Xanax, can be sedating \u2014a physical effect which isn\u2019t optimal when taken along with ketamine. So, for example, if you take sedating medication at night, it\u2019s best to schedule the ketamine treatment in the morning so the two medications don\u2019t overlap.<\/p>\n
If something doesn\u2019t feel right, speak up. Listen to your body and don\u2019t dismiss anything that feels off, no matter how minor it might be. This treatment is for you, and your comfort and wellbeing is of the utmost importance. <\/p>\n
Your provider will know the best course to take when it comes to ketamine treatment. Be upfront and honest about all other medications you are using, including the dosage and time of day taken.<\/p>\n","protected":false},"excerpt":{"rendered":"
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