Based on APNA Guidelines
Ketamine Clinic Safety Checklist
Before committing to ketamine therapy, use this 12-point checklist to evaluate any clinic’s safety standards across 4 critical categories. Print it, bring it to consultations, and ensure you’re making an informed decision.
Provider Qualifications
0/3Verify that the medical team has proper training and credentials for ketamine administration.
Ketamine therapy should be supervised by a licensed physician, ideally board-certified in psychiatry, anesthesiology, or a related specialty. This ensures proper dosing, monitoring, and emergency response capability.
The clinic lists their medical director by name with verifiable board certifications and active medical license.
No physician listed, credentials are vague, or the provider is not verifiable through state medical board records.
Beyond general medical credentials, staff should have specialized training in ketamine pharmacology, dissociative anesthesia management, and psychiatric applications of ketamine therapy.
Staff describe specialized ketamine training, ACLS certification, and ongoing continuing education in psychedelic-assisted or ketamine-assisted therapy.
Staff cannot describe their ketamine-specific training, or the clinic appears to have added ketamine without relevant expertise.
A registered nurse, certified nurse anesthetist (CRNA), or other qualified medical professional should be physically present and monitoring you throughout the entire infusion or treatment session.
A dedicated nurse or medical professional monitors you one-on-one or in a small group with continuous vital sign monitoring equipment.
You are left alone during treatment, or non-medical staff are the only ones present during your session.
Pre-Treatment Screening
0/3Ensure the clinic conducts thorough medical and psychiatric evaluations before treatment.
Before starting ketamine therapy, a qualified clinician should evaluate your mental health history, current symptoms, previous treatments tried, and appropriateness of ketamine for your specific condition.
A structured intake includes PHQ-9 or similar validated scales, treatment history review, and a face-to-face or telehealth evaluation with a licensed provider.
No formal evaluation, just a brief questionnaire, or treatment is offered without any psychiatric assessment.
Certain conditions make ketamine potentially dangerous, including uncontrolled hypertension, active substance abuse disorders, untreated hyperthyroidism, and history of psychosis. A thorough medical screening is essential.
The clinic requires vital signs, medical history review, current medications list, and screens for cardiovascular, hepatic, and substance use risk factors.
No medical screening, no discussion of your medical history, or no request for a list of your current medications.
Certain medications can interact with ketamine, including MAOIs, benzodiazepines (which may reduce efficacy), and other psychotropic medications. Your provider should review all current medications and supplements.
The provider discusses each medication you take, explains potential interactions, and may coordinate with your prescribing psychiatrist or primary care provider.
No medication review, dismissal of potential interactions, or no communication with your existing treatment providers.
Safety Protocols
0/3Confirm that proper monitoring and emergency procedures are in place during treatment.
Blood pressure, heart rate, and oxygen saturation should be monitored before, during, and after ketamine administration. Ketamine can cause temporary increases in blood pressure and heart rate.
The clinic uses pulse oximetry, blood pressure cuff, and cardiac monitoring equipment. Vital signs are checked at regular intervals and documented.
No monitoring equipment visible, vitals are only checked once, or the clinic cannot describe their monitoring protocol.
While serious adverse events are rare with sub-anesthetic ketamine doses, the clinic should have crash cart equipment, oxygen supply, suction, bag-valve mask, and emergency medications immediately accessible.
The treatment room has visible emergency equipment, staff can describe their emergency protocols, and the team is ACLS/BLS certified.
No visible emergency equipment, staff seem unsure about emergency procedures, or the facility lacks basic resuscitation supplies.
Patients should be monitored for at least 30 minutes to 2 hours after treatment (depending on route of administration) to ensure vital signs are stable, dissociative effects have subsided, and you are safe to leave.
A defined recovery period with staff check-ins, requirement that someone drive you home, and clear discharge criteria before you leave.
No observation period, you are allowed to drive yourself, or you are rushed out immediately after treatment ends.
Informed Consent
0/3Make sure you receive complete information about treatment risks, benefits, and expectations.
Before consenting to treatment, you should receive a thorough explanation of how ketamine works, realistic expectations for outcomes, potential side effects, risks specific to your health profile, and alternative treatments available.
The provider spends meaningful time discussing your specific situation, answers questions openly, provides written materials, and does not guarantee outcomes.
Rushed consent process, guaranteed cure claims, minimization of risks, or pressure to start treatment immediately.
Except for Spravato (esketamine nasal spray), ketamine use for mental health is off-label. This means it is not specifically FDA-approved for depression, anxiety, or PTSD, though it is legal and supported by growing clinical evidence.
The clinic clearly states that treatment is off-label (if not using Spravato), explains what off-label means, and references the clinical evidence supporting its use.
The clinic implies ketamine is FDA-approved for your condition (when using generic ketamine), or does not disclose the off-label status of treatment.
Responsible ketamine therapy includes a structured treatment plan with defined session frequency, expected number of sessions, criteria for evaluating progress, integration support, and a plan for maintenance or transitioning care.
A written treatment plan outlines the initial protocol, follow-up evaluation schedule, integration therapy options, and criteria for continuing or discontinuing treatment.
No defined treatment plan, open-ended sessions without progress evaluation, or no follow-up care or integration support offered.
Readiness Assessment
Needs More Investigation
The clinic you are evaluating may not meet essential safety standards. We recommend asking these questions directly and considering other options if answers are unsatisfactory.
Why Safety Screening Matters
Ketamine therapy is growing rapidly, and not all clinics maintain the same standards. These resources can help you dig deeper.
Medical disclaimer: This checklist is provided for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before starting any new treatment. The checklist criteria are informed by general clinical safety guidelines and the American Psychiatric Nurses Association (APNA) recommendations but do not constitute a formal certification or accreditation standard. Individual clinic assessment should be made in consultation with your treating physician.