Ketamine for Health & Longevity - Quick Reference Sheet

Ketamine for Health & Longevity

Created on 07/21/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 4.8 Audit

Ketamine is a decades-old anesthetic that at low doses can ease severe, hard-to-treat depression and reduce suicidal thoughts within hours. Evidence is weaker for pain, bipolar depression, trauma, and heavy drinking, and any healthy-aging benefit is unproven. Risks include temporary detachment, raised blood pressure, bladder damage, memory problems, and misuse. (Full Review)

Protocol

Standard IV
0.5 mg/kg
Racemic ketamine infused over ~40 min; ~6-infusion induction over 2–3 weeks
Esketamine (Spravato)
56–84 mg intranasal
Twice weekly during induction, then weekly or every-other-week taper
Ketamine-Assisted Therapy
Lozenges or IM
Paired with structured psychotherapy
Time to effect
Depression
Within hours
Fades over 1–2 weeks without repeat dosing
Suicidal Thoughts
Within hours
Observed up to about one week
Chronic Pain
Up to ~2 weeks
Inconsistent thereafter; may need repeat dosing

Benefits

Contraindications
  • Uncontrolled hypertension (BP persistently ≥160/100 mmHg)
  • Recent heart attack (<6 months) or unstable coronary disease
  • Aneurysm or elevated intracranial pressure
  • Active psychosis or schizophrenia
  • Current ketamine use disorder
  • Severe liver impairment (Child-Pugh Class C)
  • Pre-existing severe bladder disease
  • Pregnancy
Key Interactions
  • Benzodiazepines (diazepam, lorazepam)
  • Opioids & opioid antagonists (e.g., morphine, naltrexone)
  • Other CNS depressants & alcohol
  • CYP3A4/CYP2B6 modulators (e.g., ketoconazole, ritonavir, grapefruit, rifampin, St. John's wort)
  • Stimulants & sympathomimetics (e.g., pseudoephedrine, amphetamines, thyroid hormone)
  • Other NMDA-acting agents (memantine, high-dose magnesium)
  • Antihypertensives; theophylline

Risk & Side Effects

  • High: Acute dissociation & psychotomimetic effects; transient cardiovascular stimulation; abuse, tolerance & dependence potential
  • Medium: Ketamine-induced cystitis & urinary tract damage; nausea & vomiting; cognitive effects with repeated use
  • Low: Liver enzyme elevation
  • Speculative: Long-term neurotoxicity

Monitoring

Marker Target Why
Resting blood pressure <120/80 mmHg Ketamine transiently raises blood pressure; identifies at-risk individuals
Resting heart rate 50–70 bpm Flags baseline cardiovascular strain before a sympathomimetic drug
Liver enzymes (ALT/AST) ALT/AST ~10–25 U/L Repeated infusions can stress the liver
Urinary symptom score (IPSS) 0–7 (mild) Screens for early ketamine-induced bladder damage
Fasting glucose 70–85 mg/dL Baseline metabolic health context for a longevity-oriented reader
hs-CRP <1.0 mg/L Baseline inflammation, relevant to mood response and healthy aging

Cadence: Vitals before and during every session; symptom scales at baseline, 1 week, and 3 weeks, then every 1–3 months during maintenance; liver and urinary checks every few months on extended courses

Qualitative Assessment

  • Mood and depression severity
  • Suicidal thoughts
  • Sleep quality
  • Energy and motivation
  • Cognitive clarity
  • Pain levels
  • Tolerability of sessions