Ketamine Therapy for Depression When You Have Heart Disease: an UPDATE
- Dr. Peeva
- Sep 12
- 3 min read
The Scope of the Challenge
Heart disease is the leading cause of death in the United States, claiming over 680,000 lives every year. Millions more live with coronary artery disease, valve problems, congenital heart conditions, or rhythm disturbances such as atrial fibrillation. At the same time, depression is more common in people with heart disease than in the general population—and depression itself can worsen cardiovascular outcomes.
This overlap creates a double burden: patients are caught between emotional suffering and the physical risks of an already vulnerable heart.
Why Ketamine Is Considered
Ketamine is not new. It was first approved for medical use in 1970 and has since been used safely in settings as intense as the battlefield, in cardiac surgery, and in pediatric anesthesia. What makes ketamine stand out is its hemodynamic stability: unlike many sedatives, ketamine tends not to lower blood pressure dangerously. In fact, in certain situations it can help support circulation.
For mental health, the doses used are much lower than those used in anesthesia—what physicians call subanesthetic doses. These are given slowly, usually over 45–60 minutes, which further lowers the risk of sudden changes in blood pressure or heart rhythm.
What the Research Shows
Cardiac stability: Clinical studies in patients undergoing cardiac surgery have shown ketamine to be safer than many alternatives when it comes to maintaining blood pressure and circulation.
Subanesthetic dosing: At the levels used for depression, ketamine rarely causes serious cardiac complications. Slight increases in heart rate can occur, but they are usually well tolerated.
Mental health impact: For people with treatment-resistant depression, PTSD, or suicidal thoughts, ketamine has offered meaningful relief when other treatments have failed.
Safety Comes First
Even with this reassuring data, it is essential to stress: ketamine is not risk-free. If you have heart disease, certain conditions—such as severe coronary artery disease or uncontrolled arrhythmias—require even closer attention. The key is not the drug alone, but the expertise of the physician guiding your care.
When considering ketamine therapy, make sure you are under the supervision of a well-trained physician who:
Understands both mental health and cardiovascular disease
Reviews your medical history and current medications thoroughly
Monitors your heart rate, blood pressure, and oxygen levels before, during, and after each infusion
Has the training and equipment to respond quickly to any complication
This level of care is what transforms ketamine from simply “an option” into a safe and responsible treatment path.
The Bottom Line
For people with depression and heart disease, ketamine therapy can be both safe and effective—when it is done thoughtfully, carefully, and under expert supervision. The doses used in mental health treatment are far lower than those used in anesthesia, and when delivered by trained hands, the risk of serious cardiac side effects is low.
If depression has weighed heavily on your life and heart disease makes every treatment decision feel fraught, know this: there are safe paths forward. Ketamine may offer relief, but it should always be undertaken with the same respect we give the heart itself—with vigilance, protection, and the guidance of a physician who knows how to keep you safe.
Take the Next Step
At Propel Therapeutics, your safety is our first priority. Our team combines deep expertise in both mental health and medical care, ensuring that every infusion is tailored to your unique needs and monitored with the highest standards of safety.
If you’re ready to explore whether ketamine therapy is right for you, we invite you to reach out today. Let us walk with you—safely, compassionately, and with the most up-to-date treatment options—to help you move beyond depression and reclaim your life.
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