Is My Medication Safe to Take with Ketamine?

What You Need to Know

If you're considering ketamine therapy, one of the most important conversations you'll have with your provider is about your current medications. Some drugs are perfectly compatible with ketamine. Others require monitoring or adjustments. A few are clear contraindications.

Here's what you should understand.

Generally Compatible

SSRIs and SNRIs

Most common antidepressants — including sertraline (Zoloft), fluoxetine (Prozac), escitalopram (Lexapro), and venlafaxine (Effexor) — are generally safe to take alongside ketamine. In many cases, patients continue their existing antidepressant while adding ketamine therapy.

Requires Caution

Benzodiazepines

Medications like alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) can blunt ketamine's antidepressant effects, potentially making treatments less effective. Your provider may recommend adjusting timing or dosage.

Stimulants

ADHD medications and other stimulants can elevate heart rate and blood pressure — effects that ketamine also produces. Your provider may recommend scheduling adjustments.

Tricyclic Antidepressants (TCAs)

TCAs may increase blood pressure risk when combined with ketamine and require closer monitoring.

Mood Stabilizers

Lamotrigine and similar medications can reduce ketamine's effectiveness by dampening the glutamate response that drives its antidepressant mechanism.

Antibiotics

Most are safe, but certain classes — particularly macrolides and fluoroquinolones — can affect heart rhythm and may warrant monitoring.

Supplements

Some commonly used supplements can interfere with ketamine therapy:

• High-dose magnesium — May reduce effectiveness
• L-theanine — Can increase sedation
• St. John's Wort — Interacts with many psychiatric medications
• Sedative herbs (valerian, kava) — May compound sedation effects

Generally Avoid

MAOIs

Monoamine oxidase inhibitors carry significant blood pressure and serotonin-related risks when combined with ketamine. This is typically a contraindication.

Alcohol and Recreational Sedatives

Avoid these entirely on treatment days. The combination increases risks of respiratory depression and impaired consciousness.

The Bottom Line

Medication safety with ketamine is highly individual. What matters most is transparency with your provider. Bring a complete list of everything you take — prescriptions, over-the-counter medications, and supplements — to your initial evaluation.

Your provider can then create a treatment plan that accounts for interactions and ensures both safety and effectiveness.

For more on safety considerations, see risks and side effects and when ketamine is not appropriate.