Clonidine (Catapres) and Ketamine Therapy | Tovani Health
Catapres (Clonidine) (also: Kapvay) — Alpha-2 adrenergic agonist
Verdict at Tovani Health
Compatible; similar profile to guanfacine, additive sedation and BP changes.
Clonidine and ketamine are compatible. Same considerations as guanfacine: additive sedation and a directional BP interaction (clonidine lowers, ketamine raises transiently). Some clinicians actually use clonidine to blunt ketamine's pressor response in clinic settings.
If you take Catapres regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Catapres interacts with ketamine
Clonidine is a central alpha-2 agonist, similar mechanism to guanfacine but with stronger sedative and hypotensive effects. Reduces sympathetic outflow.
What we do at intake
Disclose dose and indication (hypertension, ADHD, opioid withdrawal, anxiety). Stand up slowly after sessions.
Bottom line
Clonidine and ketamine are compatible. Same considerations as guanfacine: additive sedation and a directional BP interaction (clonidine lowers, ketamine raises transiently). Some clinicians actually use clonidine to blunt ketamine's pressor response in clinic settings.
Frequently Asked Questions
Can clonidine make ketamine more tolerable?
It can dampen the BP rise. Whether to add it for that purpose is an in-clinic decision, not an at-home one.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Catapres (Clonidine) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Pharmacodynamic Interactions Between Ketamine and Psychiatric Medications Used in the Treatment of Depression: A Systematic Review. Veraart JKE, Smith-Apeldoorn SY, Bakker IM, et al.. International Journal of Neuropsychopharmacology. 2021. PMID: 34170315
Systematic review of pharmacodynamic interactions between ketamine and psychiatric medications used in depression treatment.
- Blood pressure safety of subanesthetic ketamine for depression: A report on 684 infusions. Riva-Posse P, Reiff CM, Edwards JA, et al.. Journal of Affective Disorders. 2018. PMID: 29525051
684-infusion case series documenting transient blood pressure elevation as the most common cardiovascular effect of subanesthetic ketamine; no serious adverse cardiovascular events.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 16, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.