At-home and telehealth ketamine
Some telehealth services prescribe compounded ketamine tablets, lozenges or sprays for use at home. These are not FDA-approved for any psychiatric condition. In October 2023 the FDA warned that using them without proper medical oversight risks serious adverse events, and that safe and effective psychiatric dosing has not been established.
What to know about compounded ketamine prescribed for use at home: the FDA's 2023 warning, the risks without monitoring, and questions to ask any provider.
Convenient, but without the safeguards that come with supervision.
Key takeaways
- Compounded ketamine is not FDA-approved for depression or any psychiatric disorder.
- Without monitoring, sedation, dissociation and blood pressure changes can go unnoticed.
- Esketamine (SPRAVATO) cannot be dispensed for home use.
- Telehealth rules for prescribing controlled substances have changed over time; check current rules with the provider.
What the FDA warned
The FDA said compounded ketamine is not approved for any psychiatric disorder, and that sedation, dissociation and changes in vital signs without proper medical oversight may put patients at risk. It also cited the potential for abuse and misuse, psychiatric events, increases in blood pressure, slowed breathing, and bladder symptoms.
Questions to ask any at-home provider
A careful provider will welcome these questions.
- Who evaluates me in person or by video, and are they a psychiatrist or physician?
- What screening do you do for blood pressure, heart conditions, psychosis and substance use?
- Who must be with me during and after each use?
- What happens if I have a bad reaction, and how do I reach you?
- How will you decide whether to continue or stop?
Safer alternatives to ask about
If ketamine is being considered, ask whether a supervised option such as esketamine at a certified clinic, or IV ketamine with monitoring, is available to you. Other well-established options for depression include therapy, antidepressants, TMS and ECT.
Frequently asked questions
Is at-home ketamine legal?
A licensed prescriber can legally prescribe compounded ketamine in some circumstances, but it is not FDA-approved for psychiatric use, and the FDA has warned about the risks of unsupervised use.
Related on Beiing
- Safety and risks - What monitoring is there to catch.
- Ketamine compared with other treatments - Other options to raise with a clinician.
- Ketamine for mental health - The hub for every page in this guide.
Sources
- FDA warns patients and health care providers about potential risks associated with compounded ketamine products, including oral formulations, for the treatment of psychiatric disorders (October 2023) - U.S. Food and Drug Administration
- SPRAVATO (esketamine) nasal spray, prescribing information - Janssen Pharmaceuticals, via DailyMed (U.S. National Library of Medicine)
- MedWatch: report a side effect - U.S. Food and Drug Administration
Written by Beiing Editorial Team · Editorially reviewed by Beiing Editorial & Research Review · Published · Last reviewed . Editorial and research review by Beiing writers and researchers. This is not medical or clinical review, and no clinician signs off on our content.
Educational content only - not medical advice. In a crisis, call or text 988 (US) or your local emergency number. See crisis resources.