Ketamine Treatment

Ketamine is a dissociative anesthetic that was developed in the early 1960s and used in human and veterinary medicine. The drug is primarily used for anesthesia.

In the 1950s, phencyclidine (PCP) was developed as an intravenous general anesthetic, but because of its severe side effects, ketamine was developed to replace it. MXE (methoxetamine) is also a similar drug made from arylcyclohexylamines.

Overview

Ketamine is a Schedule III drug, which means it is approved for use as an anesthetic in hospital and other medical settings. It is safe and effective when used in a controlled medical setting, but it also has the potential for misuse and addiction.

Also Known As: Various street names for ketamine include K, Special K, Vitamin K, super acid, super c, bump, cat Valium, green, honey oil, special la coke, and jet.

Drug Class: Ketamine is an NMDA receptor antagonist. It has anesthetic, dissociative, and hallucinogenic effects.

Common Side Effects: Ketamine can have side effects including elevated blood pressure, tremors, hallucinations, confusion, and agitation.

How to Recognize Ketamine?
Ketamine usually appears as a clear liquid or a white to off-white powder. It can also be sold illegally in pill or capsule form. It is tasteless and odorless.

What Does Ketamine Do?
In medical settings, ketamine is given intravenously to induce and maintain anesthesia. When used recreationally, it can be ingested by mouth in pill or capsule form. In liquid form, it can be injected into a vein, consumed in beverages, or added to smokable materials. Some people also inject the drug intramuscularly.

The effects of ketamine are similar to PCP, but not as severe and with a shorter duration. People who use ketamine describe the high as a pleasant sensation of floating or a dissociative state of being separated from their bodies. The drug can produce hallucinogenic-like effects, lasting a short period of time, from one to two hours.

Some people describe a feeling of complete sensory detachment, which they associate with a near-death experience.

Others describe this experience as being so deep inside the mind that reality seems distant. This state of total dissociation is called the “k-hole.”

While there is a lot of information about ketamine infusions, therapies for pain, vitamin infusions, and ketamine nasal sprays, some of it is misleading or simply false. We want to make sure we offer you some outside guidance and assistance should you choose to explore your options further.

Nashville Ketamine Center – Research, News, & Links

Ketamine Advocacy Network – Read The Science

Ketamine For The Treatment of Depression

The Dazzling Promises Of Ketamine – Dana Foundation

Antidepressant efficacy of ketamine in treatment-resistant major depression – PubMed.gov

Ketamine for the treatment of major depressive disorder and bipolar depression – PMC

Repeated oral ketamine for out-patient treatment of resistant depression – PubMed.gov

On the safety of repeated ketamine infusions for the treatment of depression – PMC

Ketamine: A New (and Faster) Path to Treating Depression – NIMH

Ketamine Offers Hope for Vets Struggling with Depression – Psychology Today

Ketamine works its magic on depression by ‘stabilizing the brain in a well state’ – CBC

Ketamine for major depression – Harvard Medical School

What You Need to Know About Ketamine’s Effects – WebMD

Ketamine for depression: Study investigates side effects – Medical News Today

How New Ketamine Drug Helps with Depression – Yale Medicine

Ketamine For The Treatment of Suicidal Ideation

How Ketamine Opens a New Era for Depression Treatment – The Washington Post

Predictors of response to repeated ketamine infusions in depression with suicidal ideation – ScienceDirect

Ketamine’s Therapeutic Value in Suicidal Patients – EMRA

Ketamine Found to Rapidly Reduce Suicidal Thoughts in Depressed, Suicidal Patients in ER – Psychiatric News

Ketamine improves suicidal ideation in veterans with PTSD, MDD – Healio Psychiatry

Ketamine for suicidal ideation in adults with psychiatric disorders – Sage Journals

Effects of ketamine treatment on suicidal ideation: a qualitative study – BMJ Journals

Ketamine For The Treatment of PTSD

Why Ketamine Infusion Therapy Was the PTSD Breakthrough I Needed – The Mighty

FDA-approved ketamine found to help with PTSD, depression – WSMV

Veteran says ketamine infusions helped with PTSD – Fox21 News

Should You Use Ketamine to Treat PTSD? – Health Central

3 Reasons Why Ketamine May be a PTSD Treatment Option – Reset Nero Therapy

Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder – PubMed.gov

Ketamine as treatment for post-traumatic stress disorder – PMC

Therapeutic Challenges of Post-traumatic Stress Disorder: Focus on the Dopaminergic System – frontiers

Ketamine For The Treatment of Cancer Pain

Ketamine for Pain in Adults and Children with Cancer: A Systematic Review and Synthesis of the Literature – Oxford Academic

Ketamine Protocol for Palliative Care in Cancer Patients With Refractory Pain – PMC

The role of ketamine in the treatment of chronic cancer pain – PMC

Intrathecal ketamine reduces morphine requirements in patients with terminal cancer pain – Spring Link

Ketamine as an adjuvant to opioids for cancer pain – Europe PMC

Ketamine For The Treatment of Complex Regional Pain Syndrome (CRPS) and Neuropathic Pain:

What is complex regional pain syndrome? – NINDS

How effective is ketamine in the management of chronic neuropathic pain? – Future Medicine

Complex regional pain syndrome diagnosis & treatments – Mayo Clinic

When Nothing Seems to Help Your CRPS, Ketamine Pain Treatments May Bring Relief – Cleveland Clinic

Ketamine For The Treatment of Fibromyalgia

Ketamine In Acute and Chronic Pain Management – NCBI

Breakthrough Treatment IV Ketamine Infusions for Depression, PTSD, CRPS, Fibromyalgia, Chronic Lyme, Rheumatoid Arthritis – BioSpace

If You’re Living With Fibromyalgia Pain, Ketamine Can Help – Pain Medicine Consultants

Psychiatric Uses
Ketamine has been shown to have antidepressant effects in patients with mood disorders, so it is has been sometimes used intravenously off-label to help treat major depressive disorder and bipolar disorder.

In 2019 the FDA approved an intranasal form of ketamine for use in treatment resistant depression. There is still much to learn on the safety and long-term effects of the psychiatric use of ketamine.

Some research has also found that ketamine can reduce symptoms of post-traumatic stress disorder (PTSD).

Common Side Effects
Some of the common short-term side effects that people experience include:

• Visual disturbances
• Confusion and disorientation8
• Drowsiness
• Increased heart rate
• Elevated blood pressure
• Nausea and vomiting
• Euphoria8
• Sedation

Depending on the dosage, some can experience these more severe side effects of ketamine:

• Severe allergic reaction
• Hypotension and heart rhythm abnormalities
• Difficulty talking
• Abnormal movements
• Slowed or depressed breathing

Signs of Use

Some of the signs that someone might be using ketamine include:

• Changes in sleep habits
• Irritability
• Mood changes9
• Hallucinations
• Difficulty speaking
• Memory problems9
• Disorientation
• Presence of drug paraphernalia

Typically, the outward symptoms of ketamine overdose are the psychotropic effects, including dreams, illusions, and hallucinations—similar to LSD and PCP use. Benzodiazepines might be given to reduce agitation. This requires caution, however, as in cases of ketamine overdose, ketamine was typically not the only drug ingested. Over-sedation and drug interactions are a concern.

If you believe that someone has overdosed on ketamine or another substance, contact emergency services immediately.

Tolerance, Dependence, and Withdrawal
The use of ketamine can result in tolerance, dependence, and symptoms of withdrawal. When tolerance occurs, people require larger or more frequent doses of the drug to achieve the same effects they felt initially. Dependence occurs when a person needs to continue taking a drug in order to avoid the negative effects of withdrawal.

How Long Does Ketamine Stay in Your System?
Ketamine has a half-life of approximately three hours , which means that it takes approximately 14 to 18 hours for the drug to be eliminated from a person’s system. The exact range of time, however, depends on a variety of factors including how much of the drug was used as well as the individual’s body mass, hydration levels, and metabolism.

While ketamine may be cleared from the body within a day or two, it may be detectable in urine tests for up to 14 days and in hair follicle tests for up to 90 days.

Addiction
The National Institute on Drug Abuse reported in 2019 that a bit less than 0.1% of people in 12th grade had used ketamine in the past year.

Addiction to ketamine can cause chemical changes in the brain’s reward system that make it very difficult to stop taking the drug. Because ketamine creates feelings of detachment, people often experience major disruptions in multiple life areas once they have developed an addiction.

Signs of addiction can include neglecting work and family responsibilities and spending large amounts of money on the drug. The high from ketamine is short-lived and tolerance tends to build quite quickly, meaning people who use it need to increase the amount they use in order to get the same results.

It can also be difficult for those using the drug to gauge how much of the drug they need for their desired effect, which can lead to overdose.

Withdrawal

Once people have become tolerant, dependent, or addicted to ketamine, they are likely to experience symptoms of withdrawal when they stop taking it. These symptoms can range in severity from mild to more serious.

Symptoms of withdrawal can include:

• Depression
• Anxiety
• Rapid heartbeat
• Fatigue
• Lack of appetite
• Insomnia
• Nightmares
• Restlessness
• Tremors
• Chills or sweats
• Anger

Because ketamine withdrawal symptoms can sometimes be serious, it can be helpful to go through the detox and withdrawal process under the supervision of trained addictions recovery professionals.

How to Get Help
While ketamine use and addiction is serious, there are effective treatment options available. Treatment options may include cognitive-behavioral therapy (CBT), individual therapy, group therapy, family therapy, motivational enhancement therapy, or other approaches.

Treatment may occur on an inpatient, outpatient, or residential basis.

While there are no specific medications approved for the treatment of addiction to ketamine, interventions may include the use of medications to treat co-occurring psychiatric conditions.