Is Ketamine Safe During Pregnancy?

Pregnancy and the postpartum period carry elevated risk for depression, anxiety, and other mental health conditions. For patients who have found relief through ketamine therapy, discovering a pregnancy raises an immediate and understandable question: is ketamine safe to continue? A 2026 review published in PMC and a 2024 study on pregnancy safeguards provide the most current data on this complex topic.

Important note: This article summarizes research findings and is not medical advice. Decisions about any medication during pregnancy should be made with your treating physician and obstetrician.

What the Research Says

The 2026 PMC Review

The 2026 PMC review examined the available literature on ketamine use in the context of perinatal mental health. The review assessed animal studies, case reports, observational data, and the limited clinical research involving pregnant or postpartum patients.

Key takeaways from the review:

• Animal data raises concerns. High-dose, prolonged ketamine exposure in animal models has been associated with neurodevelopmental effects in offspring, including changes in neuronal apoptosis (programmed cell death) during critical brain development periods. However, the doses used in these studies are typically far higher than those used in therapeutic settings for depression.
• Human data is extremely limited. There are no randomized controlled trials of ketamine for depression in pregnant patients, and ethical considerations make such trials unlikely in the near future. The available human data comes primarily from case reports and observational studies of ketamine used as an anesthetic during cesarean sections and other surgical procedures.
• Anesthetic use provides some safety signals. Ketamine has been used as an anesthetic agent during pregnancy for decades, particularly in low-resource settings. At anesthetic doses (higher than those used for depression treatment), short-term use has not been consistently associated with adverse fetal outcomes. However, this data has significant limitations and does not directly address repeated sub-anesthetic dosing for mental health.
• No established safe dose for repeated use. The review concluded that there is currently insufficient evidence to establish a safe dosing regimen for repeated sub-anesthetic ketamine administration during pregnancy.

The 2024 Pregnancy Safeguards Study

A 2024 study focused specifically on the pregnancy safeguards implemented by ketamine therapy providers. The study surveyed clinics and telehealth programs to assess what screening protocols, consent processes, and monitoring practices were in place for patients of childbearing age.

The study found significant variability across providers:

• Some programs required pregnancy testing before each ketamine session, while others relied on self-report.
• Consent forms varied widely in how they communicated the limited safety data during pregnancy.
• Few programs had formal protocols for managing patients who became pregnant during treatment.

The authors recommended standardized pregnancy screening and counseling as part of all ketamine therapy programs.

Current Clinical Consensus

Based on the available evidence, the current clinical consensus is cautious:

Ketamine therapy is generally not recommended during pregnancy due to insufficient safety data. This is not because harm has been definitively demonstrated at therapeutic doses, but because the evidence needed to confirm safety does not yet exist.

Most ketamine therapy providers, including Isha Health, screen for pregnancy and advise patients to use reliable contraception during treatment. Patients who become pregnant during a course of ketamine therapy are typically advised to pause treatment and consult with their obstetric care team.

The Risk-Benefit Conversation

For patients with severe, treatment-resistant depression during pregnancy, the calculation is not straightforward. Untreated maternal depression carries its own significant risks, including preterm birth, low birth weight, impaired maternal-fetal bonding, and increased risk of postpartum depression.

In rare cases where a pregnant patient's depression is severe and unresponsive to safer alternatives (such as certain SSRIs with established safety profiles in pregnancy, psychotherapy, or TMS), clinicians may weigh the unknown risks of ketamine against the known risks of untreated severe depression. These decisions should involve a multidisciplinary team including the prescribing psychiatrist, obstetrician, and the patient.

What About the Postpartum Period?

The safety considerations differ for postpartum patients who are not breastfeeding. In these cases, ketamine therapy can be considered under the same guidelines as for any other adult patient with depression.

For patients who are breastfeeding, ketamine's transfer into breast milk and potential effects on the nursing infant have not been well-studied. Some providers advise a "pump and dump" approach for a defined period after each session, but standardized guidelines do not yet exist.

For information on ketamine's role in treating postpartum depression (in non-pregnant patients), see our page on ketamine for postpartum depression.

What This Means for Patients

If you are pregnant or planning to become pregnant:

• Discuss your treatment plan with your physician before making any changes to your ketamine therapy.
• Do not stop any medication abruptly without medical guidance, as withdrawal or sudden discontinuation can also carry risks.
• Explore alternative treatments that have more established safety profiles during pregnancy.
• Plan ahead if possible: if you are considering pregnancy, discuss timing with your ketamine prescriber to develop a transition plan.

For comprehensive safety information about ketamine therapy, see our safety information page.

The Bottom Line

The honest answer to "Is ketamine safe during pregnancy?" is that we do not yet know with certainty. The limited available evidence does not demonstrate clear harm at therapeutic doses, but neither does it provide the reassurance needed to recommend use during pregnancy. The prudent approach, supported by both the 2026 PMC review and the 2024 safeguards study, is to avoid ketamine therapy during pregnancy unless the clinical situation is severe enough to justify the unknown risks.

Considering ketamine therapy? Isha Health offers physician-led at-home treatment with an 88.8% improvement rate. Check appointment availability.