At-Home Ketamine Research: What a Sublingual Study Can and Cannot Show

Important: Compounded ketamine is not FDA-approved. FDA has not evaluated its safety, effectiveness, or quality before marketing. Ketamine injection is approved for anesthesia, not psychiatric conditions. Compounded ketamine nasal spray is different from FDA-approved Spravato (esketamine), and research on other formulations or treatment settings does not establish its benefits.

At-home ketamine studies are sometimes used to promote every kind of home treatment. Reading the original methods helps show why the medication route and study design must stay part of the story.

What treatment was studied?

A 2022 prospective, open-label study examined sublingual ketamine, taken under the tongue, within a telehealth-supported program over four weeks. It did not study nasal spray. The report included 1,247 participants who completed treatment with sufficient data.

Among that analyzed sample, 62.8% reported at least a 50% reduction on the PHQ-9 depression measure and 62.9% did so on the GAD-7 anxiety measure. These figures describe specified measures in that sample. They are not predicted success rates for other programs or formulations.

Why the limitations matter

Open-label means participants and clinicians knew the treatment being given. There was no randomized comparison group, so the design cannot isolate medication effects from expectations, support, other care, or changes over time. The authors also identified a need to study how durable the effects were.

A large sample does not remove those limitations. Results restricted to people with sufficient follow-up data may not describe everyone who began care. A short observation period also cannot settle longer-term safety questions or reliably rule out uncommon serious harms.

Why this is not evidence for a compounded spray

A medicine absorbed under the tongue differs from a nasal formulation. Dose, formulation, additional ingredients, patient selection, and monitoring can all differ. The study did not evaluate Bliss Mist Rx’s nasal medication and cannot establish that product’s safety or effectiveness.

The wording of a paper’s title is the authors’ characterization, not FDA approval. Avoid using largest-ever, proven safe, or clinic-equivalent as shortcuts for evaluating a specific prescription.

Questions for your clinician

Ask which studies match the proposed route and formulation, what important gaps remain, and what approved alternatives could meet your needs. Discuss how adverse effects would be recognized, who would respond, and whether home treatment provides an appropriate level of care.

Telehealth can support communication, but it cannot supply a healthcare professional at the bedside when a serious reaction occurs.

Safety and the treatment setting

Ketamine can cause sedation, dissociation, impaired thinking or coordination, nausea, increased blood pressure or heart rate, and slowed breathing. Abuse or misuse, worsening psychiatric symptoms, and urinary or bladder problems are also concerns. This is not a complete list of risks.

At home, a healthcare professional is not onsite to monitor you or respond immediately to an adverse reaction. Telehealth support does not provide the same monitoring as an onsite care team. Review these FDA ketamine risk alerts and discuss your health history, other medications, monitoring needs, and emergency plan with your clinician.

Discuss your options

Bliss Mist Rx LLC provides telehealth services; we do not manufacture or compound medication. If a clinician prescribes treatment, an independent, appropriately licensed compounding pharmacy dispenses it. A consultation does not guarantee a prescription or a particular outcome. Book a Free Virtual Appointment or Follow-Up to discuss questions about your care.

This article is general education and does not replace individualized medical advice.