Ketamine Drug Interactions with Common Psychiatric Medications

A medication once primarily known for its anesthetic properties, ketamine has emerged as a beacon of hope in the treatment of various psychiatric conditions. However, as with any medication, understanding its interactions with other drugs is crucial for safety and effectiveness. This article surveys drug interactions of ketamine with common psychiatric medications, providing insights into potential risks and necessary precautions.

In general, ketamine has relatively few interactions of concern with other medications, and the problems that do exist are easily addressed with proper medical supervision — which is an integral part of the Nue Life ketamine therapy program. 

Does Ketamine Interfere with Other Psychiatric Medications?

When considering ketamine therapy, it's essential to discuss current medications with healthcare providers in the onboarding process. Ketamine can interact with a range of drugs, affecting its efficacy and safety. Mutual awareness and understanding between the patient and medical care provider regarding these interactions ensure a tailored and safe treatment approach.

Ketamine Interactions in the Brain

Ketamine works by interacting with the NMDA receptors and glutamate receptors in the brain and can offer rapid antidepressant effects. However, its interaction with medications like benzodiazepines and SNRIs can alter the impact of ketamine on depression and ketamine on anxiety, highlighting the importance of a comprehensive medication review before starting treatment.

Xanax and Ketamine Interaction

Xanax (alprazolam), a benzodiazepine, is commonly prescribed for anxiety. Mixing Xanax with ketamine can increase sedation, leading to heightened risks during ketamine therapy. Even if prescribed by a physician or psychiatrist, using ketamine together with Xanax may increase side effects such as dizziness, drowsiness, confusion, difficulty concentrating, excessive sedation, and respiratory depression. Some people may also experience impaired thinking, judgment, and motor coordination. 

This doesn’t necessarily mean that the interactions are negative or adverse, just simply something to be aware of more closely. 

Close monitoring and adjustment of dosages might be required to mitigate these effects – that’s why Nue Life includes so many care provider touchpoints in the at-home ketamine therapy protocol. 

Ketamine and other Benzodiazepines

As a whole, the benzodiazepine class of medications has been known to reduce the antidepressant effects of ketamine over time. It could potentially be subject to the same side effects as Xanax. 

Any patient in the Nue Life program will be asked to discuss this with their medical care provider as you may be asked to hold specific medications/substances the day of their experience. 

Ketamine and Alcohol Interaction

Alcohol and ketamine are both central nervous system (CNS) depressants. Combining them can lead to severe sedation, respiratory depression, and an increased risk of unconsciousness. Nue Life advises patients to avoid excess alcohol during ketamine treatment periods, but to ultimately consult with a medical provider before altering regular habits.

Ketamine and SSRIs  

Selective serotonin reuptake inhibitors – commonly abbreviated as SSRIs – are a class of drugs that are typically used to treat conditions like depression and anxiety. Prescriptions can last over several months & years, and have been noted for their effect on “baseline” levels of anxiety and depression as opposed to acute, episodic treatment. 

Some names of SSRIs you might recognize include: 

• Citalopram (Celexa), 
• Escitalopram (Lexapro, Cipralex), 
• Sertraline (Zoloft), 
• Fluoxetine (Prozac), 
• Paroxetine (Paxil, Pexeva)

Ketamine acts on the NMDA receptors and the glutamate receptors in the brain, steering ketamine’s mechanism of action clear from SSRIs – which typically interact on serotonin and serotonin receptors. 

Previous data has shown that ketamine addition to regular antidepressants is safe and can sometime retain ketamine’s typical properties of accelerating the antidepressant response. Nue Life recommends a detailed conversation with a medical provider before starting ketamine therapy however, as there have been reports of SSRIs mildly dulling the effects of ketamine.

Ketamine and SNRIs  

Serotonin–norepinephrine reuptake inhibitors – SNRIs – are a category of antidepressant drugs used to treat a host of conditions like depression and anxiety but have seen other use cases for treating things such as attention-deficit hyperactivity disorder, social phobia, chronic neuropathic pain, fibromyalgia and more. 

Overall, an SNRI regimen is safe to retain during ketamine treatment – however, some SNRIs have been known to increase blood pressure in patients. For this reason, it’s always recommended to discuss this closely with a medical provider before embarking on a healing journey with ketamine. 

Medications That Don’t Interfere With Ketamine Infusions

Not all medications interact negatively with ketamine. For example, most SSRIs and SNRIs do not have significant adverse interactions, making them safe to use during ketamine therapy. However, individual responses may vary; consultation with a healthcare provider is always recommended.

An Overview of Ketamine Drug Interactions

Ketamine's potential in treating psychiatric conditions is undeniable, but its interaction with other medications underscores the need for careful consideration and management. By understanding these interactions, patients and healthcare providers can navigate the complexities of ketamine therapy, ensuring safety and maximizing therapeutic outcomes.

Compared with the majority of medications, ketamine has relatively few interactions of concern and the ones that do exist are easily addressed with proper medical supervision — which is an integral part of the Nue Life ketamine therapy program.

‍