IV Therapy for Anxiety
IV Ketamine Therapy for Anxiety Disorders
IV ketamine therapy is a physician-directed treatment that may be considered for adults living with certain anxiety disorders, particularly when standard treatments have not provided sufficient relief.
Ketamine has been authorized in Canada for use as an anesthetic medication. Its use in mental health conditions involves lower, sub-anesthetic doses administered in a monitored medical setting.
Research into ketamine for anxiety disorders is ongoing. Some studies suggest it may reduce symptoms in select patients. However, outcomes vary, and long-term data are still evolving.
Anxiety Disorders We May Assess For
IV ketamine therapy may be considered, after assessment, for adults diagnosed with conditions such as:
- Generalized Anxiety Disorder (GAD)
- Social Anxiety Disorder
- Panic Disorder
- Anxiety associated with depression
IV ketamine is not considered a first-line treatment for anxiety disorders. Standard care typically includes psychotherapy (such as cognitive behavioural therapy) and/or medication.
Regulatory Information
In Canada, ketamine is approved for use as an anesthetic. The use of IV ketamine for anxiety disorders is considered an off-label medical use, meaning it is prescribed based on clinical judgment and available scientific evidence but is not specifically authorized by Health Canada for this indication.
Patients are informed of this status as part of the consent process.
How Ketamine May Work in Anxiety
Ketamine acts on the brain’s glutamate system, which plays a role in mood regulation, stress response, and neural connectivity.
Research suggests ketamine may:
- Influence neural circuits involved in fear and stress
- Support neuroplasticity (the brain’s ability to form new connections)
- Reduce symptoms in some individuals more rapidly than conventional medications
Some patients report symptom improvement within days. However:
- Not all individuals respond
- Benefits may be temporary
- Ongoing evaluation and follow-up are required
What to Expect During Treatment
1. Comprehensive Assessment
Before treatment, a physician will review:
- Current symptoms and diagnosis
- Psychiatric and medical history
- Past medication trials
- Current medications
- Potential risks and contraindications
If appropriate, an individualized treatment plan will be developed.
2. The Infusion Appointment
- Ketamine is administered intravenously over approximately 40 minutes
- Blood pressure, heart rate, and oxygen levels are monitored
- A qualified healthcare professional remains present
- Patients are observed after treatment until medically stable
Temporary effects during infusion may include:
- Altered perception
- Feeling detached or relaxed
- Mild dizziness
These effects typically resolve shortly after the infusion.
Patients must arrange transportation home and should not drive or operate machinery until the following day.
3. Treatment Course
An initial treatment series may involve multiple infusions over several weeks. The number and frequency of treatments depend on clinical response and physician assessment.
If maintenance treatments are considered, they are individualized.
Risks and Side Effects
When administered in a controlled medical setting, IV ketamine is generally well tolerated in appropriately screened patients.
Possible short-term side effects include:
- Nausea
- Dizziness
- Temporary dissociation
- Elevated blood pressure
- Fatigue following treatment
Less common but possible risks:
- Psychological discomfort during infusion
- Cardiovascular effects
- Potential misuse risk outside medical supervision
Long-term safety data for repeated use in anxiety disorders continue to be studied.
Ketamine may not be appropriate for individuals with:
- Uncontrolled hypertension
- Certain cardiovascular conditions
- Active psychosis
- Untreated substance use disorders
- Pregnancy
All potential risks, benefits, and alternative treatment options are discussed prior to proceeding.
Coverage and Fees
IV ketamine therapy for anxiety disorders is not covered by OHIP (Ontario Health Insurance Plan).
As this treatment is not publicly funded for this indication, it is typically provided on a private, fee-for-service basis. Patients are responsible for associated costs unless private insurance reimbursement applies.
Patients are encouraged to verify coverage directly with their insurer.
Important Information
IV ketamine therapy is not a cure for anxiety disorders. It may reduce symptoms in some individuals, and results vary.
Treatment should be part of a comprehensive mental health care plan, which may include psychotherapy, medication management, and ongoing psychiatric follow-up.
If you are experiencing a mental health crisis or thoughts of self-harm, call 911 or attend your nearest emergency department immediately.
