If you’re thinking about starting ketamine treatment for depression, anxiety, or suicidal thoughts, you might have questions about how it shows up on drug tests, especially if you have to take drug tests for work, legal reasons, or medical procedures. One common question we hear from patients is, “Does ketamine show up on a 12-panel drug test?”

What Is a 12-Panel Drug Test?
A 12-panel drug test is a common type of urine drug screening used by employers, legal systems, rehab centers, and medical providers. It screens for 12 different types of drugs or drug classes.

Here’s what a standard 12-panel test usually checks for:

1. Amphetamines (e.g., Adderall)
2. Barbiturates
3. Benzodiazepines (e.g., Xanax, Valium)
4. Cocaine
5. Marijuana (THC)
6. Methadone
7. Methamphetamines
8. Opiates (e.g., heroin, morphine)
9. Phencyclidine (PCP)
10. Propoxyphene (a pain medication)
11. MDMA (Ecstasy)
12. Tricyclic Antidepressants (TCAs)
13. Possibly Buprenorphine (becoming more common)

Ketamine is not typically included on a standard 12-panel drug test. It can be detected if the test is specially designed to look for it, such as in expanded panels or when specifically requested.

Will Ketamine Show Up on a Drug Test?
Most standard drug screens do not test for ketamine unless the test is customized to include it. In workplace or routine legal settings, ketamine is usually not part of the drug testing panel. Some advanced or expanded drug panels, such as 14-, 16-, or 18-panel tests might include it.

Detection window for ketamine in urine:

• Ketamine can usually be detected in urine for 2 to 4 days after use.
• In chronic use or high-dose scenarios, it may be detected for up to 2 weeks.

If you're concerned about drug testing and are using ketamine as part of a prescribed treatment plan, it's important to tell your employer or testing agency in advance (if needed), and have documentation from your provider.

Can Ketamine Cause a False Positive?
While rare, ketamine may cause a false positive for PCP (phencyclidine) due to the chemical similarities between the two substances. This is most likely to happen on older or less specific urine drug tests.

If a false positive occurs, a GC/MS (gas chromatography/mass spectrometry) confirmatory test will clarify the results and show the difference between ketamine and PCP. These confirmatory tests are highly accurate and typically follow any positive result from an initial screen.

Is Ketamine Safe?
Ketamine was first approved in the 1970s as a surgical anesthetic. In recent years, it has been used in much lower doses to treat mental health conditions, especially when traditional antidepressants have failed.

That said, ketamine is not risk-free. Potential side effects include:

• Dissociation (feeling disconnected from reality or the body)
• Dizziness or nausea
• Increased blood pressure
• Headaches
• Temporary anxiety or confusion

When used medically and under supervision, psychiatric oversight, the risk of serious side effects is low.

Ketamine also has the potential for misuse or addiction. In clinical settings, dosages are controlled and patients are carefully monitored. Clinics ensure that ketamine is used safely and only for appropriate mental health indications.

Why Is Ketamine Used for Mental Health?
Ketamine is different from most other psychiatric medications. It acts on NMDA receptors in the brain instead of the serotonin or dopamine systems like many antidepressants.

This different mechanism allows ketamine to work much faster than traditional medications, often in hours or days, rather than weeks.

Ketamine has shown powerful results in treating:
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1. Treatment-Resistant Depression
According to research from the American Journal of Psychiatry, about 60-70+% of patients with treatment-resistant depression experience significant improvement after ketamine treatment.

2. Suicidal Thoughts
One of ketamine’s most impressive benefits is its ability to rapidly reduce suicidal thinking. In a 2020 study published in JAMA Psychiatry, patients receiving ketamine reported a significant drop in suicidal thoughts within 24 hours of their first dose.

3. Anxiety
While ketamine is not officially FDA-approved for anxiety, growing research supports its benefit for conditions like generalized anxiety disorder and social anxiety. One study from Neuropsychopharmacology showed that patients with social anxiety disorder experienced long-lasting relief after a single dose.

Is It Worth the Risk?
Mental health conditions like depression, suicidality, and anxiety can be life-threatening. For patients who haven’t responded to traditional treatments, ketamine offers a new and promising path forward.

Benefits of Ketamine Therapy:

• Rapid improvement in mood
• Reduction of suicidal thoughts
• Improvement in quality of life
• Increased motivation and energy
• May reduce the need for long-term hospitalization or ER visits

Over 80% of patients with treatment-resistant depression see some improvement with ketamine, according to multiple clinical trials. When combined with psychotherapy (known as ketamine-assisted therapy), the benefits can be even greater and longer-lasting.

Key Takeaways

• Ketamine does not show up on a standard 12-panel drug test, but it may appear on expanded drug panels.
• It can occasionally cause a false positive for PCP, though confirmatory testing can clarify this.
• Ketamine is used under medical supervision for treatment-resistant depression, suicidal thoughts, and anxiety.
• Research shows 60-80+% of patients improve, often within hours to days.
• Risks include dissociation, nausea, dizziness, and, in rare cases, psychological dependency.
• Ketamine therapy should always be guided by a trained medical provider or psychiatrist.

Mental health treatment is deeply personal. For many patients, ketamine offers hope after years of frustration. While it’s not the right fit for everyone, it has changed and even saved many lives.

​Ketamine has been in use as an anesthetic and sedative in operating and emergency rooms since around 1970. More recently, studies have demonstrated its effectiveness in mental health, most notably in patients with chronic, treatment-resistant conditions like anxiety, depression, PTSD, and chronic pain. Ketamine Assisted Psychotherapy (KAP) is an emerging treatment in psychiatry and psychotherapy.  It combines the medicinal effects of ketamine with therapy in a state that better allows you to access difficult emotions and memories.  Sometimes we can gain access to our subconscious to better understand our desires and past memories.  

Ketamine is the only current psychedelic substance approved by the Federal Drug Administration (FDA). The effects of Ketamine can lead to relief of everyday distressing emotional, physical, and mental states. Ketamine is thought to be helpful therapeutically as the psychedelic effects lead to non-ordinary states of consciousness where fear of difficult feelings, thoughts, and sensations are lessened.  This can allow for more advanced therapy to occur.

Ketamine shows promise in clinical studies for rapid symptom reduction for individuals with treatment-resistant depression including a reduction in suicidal thoughts.  The rapid reduction of symptoms stands out against common psychiatric medications that require weeks for full effect. Traditional talk therapy can take months for significant symptom reduction.  Ketamine is considered a NMDA receptor antagonist, but it also works by encouraging neuroplasticity (neuronal growth). 

Ketamine assisted psychotherapy takes place in the office under the care of dedicated, trained staff. Psychiatrists analyze patient fitness for ketamine. Individuals with chronic heart issues, hyperthyroidism, and uncontrolled hypertension should not take ketamine. It is important to disclose all over-the-counter and prescription medications to staff to avoid interactions. Studies that focus on ketamine often utilize a treatment plan that begins with approximately six sessions in the first 2-4 weeks and then tapered maintenance sessions.  Treatment that involves therapy will typically include being in the clinic for 2-3 hours.

The optimal dosage and modality are determined based on the ketamine experience by the patient and assessment by the psychiatrist. Therapists working with clients will reassure, validate, and deeply listen to each patient while anchoring the KAP session. In this safe environment, the patient is able to engage with the effects of ketamine and begin the journey to long term change.

While some clinics focus on providing ketamine intravenously in a medical setting, we believe long term change better occurs when combining ketamine with counseling in a more relaxed setting.  Accessing and addressing trauma, frustrations, and emotions that hold us back can better allow for change to occur.

Common side effects include out of body experiences, increased heart rate and blood pressure, dizziness, nausea, and sedation. These side effects typically dissipate within a few hours. Patients in ketamine treatment are not safe to drive for approximately 12 hours, so patients must leave the office with a designated driver. 

Ketamine treatment is for patients who have tried psychiatric medications or are looking for another option for treatment-resistant depression and other related disorders. Ketamine is not the only alternative. Other options for treatment-resistant depression include transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). Symptom alleviation may not be permanent, and may require further ketamine treatments. 

If you believe you may be a candidate for Houston ketamine assisted psychotherapy, contact our office at 281-849-4080 for a psychiatric consultation.