It’s one of the most common questions we receive, and it’s a thoughtful one. Ketamine therapy is not right for every person or every situation — and part of what makes Seaside Ketamine different from high-volume infusion centers is that we take candidacy assessment seriously. We evaluate every prospective patient carefully before recommending treatment, and we’ll tell you honestly if we don’t think ketamine is the right fit for your situation.
This article will walk you through who tends to respond best to ketamine therapy, who may not be an appropriate candidate, and what the evaluation process looks like from start to finish.
Ketamine is most appropriate for patients who have already tried first-line treatments for their condition — typically antidepressant medications and/or psychotherapy — without achieving satisfactory results. This doesn’t mean you need to have failed five medications over ten years. Even patients with a moderate history of treatment difficulty may be appropriate candidates, particularly if their current quality of life is significantly impaired.
At Seaside Ketamine, we evaluate and treat patients with:
Ketamine therapy is most effective when patients approach it with intention. This doesn’t mean having everything figured out or adopting any particular belief system. It means a willingness to reflect on your experiences, openness to what may emerge during treatment, and a commitment to integration — the work of making meaning from the experience and embedding the insights into daily life.
Patients who treat ketamine as a passive medical procedure tend to get less out of it than those who treat it as an active element of their healing. This is something we discuss directly with every patient.
Ketamine is not a guaranteed cure, and we’ll never represent it as one. Most patients experience meaningful improvement; some experience dramatic, lasting transformation. A smaller percentage don’t respond well or respond initially and then return to baseline without continued treatment. We’ll have an honest conversation about what you can realistically expect based on your specific history.
Ketamine’s dissociative properties can worsen psychotic symptoms. Patients with active schizophrenia, schizoaffective disorder, or other conditions with prominent psychosis are generally not appropriate candidates — unless the presentation is atypical and very carefully evaluated.
Ketamine transiently increases heart rate and blood pressure during the infusion. Patients with poorly controlled hypertension, recent myocardial infarction, severe arrhythmia, or significant structural cardiac disease may need cardiology clearance or may not be appropriate candidates.
Ketamine has abuse potential, and active substance use disorder — with the notable potential exception of alcohol use disorder where ketamine may actually be therapeutic — requires careful evaluation. We review each situation individually and do not have a blanket exclusion policy, but active daily problematic substance use is typically a reason to defer treatment until stability is established.
Some medications require adjustment or temporary discontinuation before ketamine therapy. MAOIs (monoamine oxidase inhibitors — very old antidepressants rarely prescribed today) are contraindicated and must be fully cleared before ketamine can begin. We review all medications during the intake process and flag any that require management.
Ketamine is not used during pregnancy.
Step 1: Free 15-Minute Consultation A no-pressure phone or video call to discuss your situation, answer initial questions, and determine whether a full evaluation makes sense. No cost, no commitment.
Step 2: Comprehensive Medical and Psychiatric Intake A thorough, individualized review of your medical history, psychiatric history, medication history, substance use history, and current symptoms. For some patients, we may request lab work or medical clearance from a primary care physician or specialist before proceeding.
Step 3: Personalized Treatment Planning If you’re a good candidate, Dr. Gillin will discuss a specific, personalized protocol — including the number of sessions, route of administration (IV vs. IM), integration support structure, and any medication adjustments — tailored specifically to your situation.
The process is thorough because the outcome matters. We want to be fully confident that ketamine therapy is the right tool for your situation before you invest your time, energy, and money.
If you’re wondering whether you might be a candidate, the best next step is simply a conversation.
