While ketamine works very well in bipolar patients, those with psychotic features must maintain their antipsychotic while undergoing ketamine therapy.
Ketamine does nothing to solve psychosis and mania, so use a mood stabilizer such as lamictal, and an antipsychotic such as risperidone, along with a stimulant and sleep medication if those are part of your routine.
Ketamine does not solve ADD/ADHD and mania or cure wake and sleep issues.
Note lamictal and risperidone have been shown to lower the effectiveness of ketamine. See the contraindications page for more information.