What is ketamine?
Ketamine is an anesthetic drug that is also used as a treatment for depression. Because it can cause a sense of dissociation and euphoria, ketamine is also misused as a “club drug”. Ketamine has side effects, including psychological disturbances, and should only be used under direct physician supervision.
What does ketamine do?
Ketamine is an anesthetic drug and chemical cousin of phencyclidine (PCP). Initially created by the Parke-Davis Pharmaceutical Company in 1962, ketamine has been used in the United States as a human and veterinary anesthetic drug since 1970. Ketamine reduces pain and results in amnesia. Unlike many other anesthetic drugs, ketamine does not significantly affect most people’s ability to breathe. Ketamine also has anti-inflammatory effects in some individuals.
What is ketamine therapy?
Although ketamine has been used in the United States as an anesthetic drug since the 1970’s, its popularity as a treatment for depression has increased in recent years. Instead of being given in an operating room, ketamine therapy for depression is often administered to patients in a doctor’s office or clinic. Ketamine therapy may be provided orally, through an intravenous infusion, or by intranasal administration. Since the beneficial effects of ketamine in the treatment of depression are not long-lasting, individuals who receive ketamine therapy may require administration of repeated doses of the drug at weekly or monthly intervals.
What are the side effects of ketamine?
Ketamine’s psychological side effects include dissociation. Dissociation is the feeling of being “spaced out” or dreaming. In some cases, the feeling of dissociation may be unpleasant, and individuals may experience distressing “out of body” experiences that are referred to as the “K-hole”. During periods of dissociation related to recreational ketamine use, affected individuals can experience falls or other traumatic injuries that may be serious or even fatal. Ketamine causes increases in heart rate and blood pressure that typically last for 1-2 hours after it’s given. Ketamine also affects the lining of the urinary bladder, and repeated use can lead to urinary urgency, painful urination, and incontinence. The medical term for this syndrome is “interstitial cystitis” or “ulcerative cystitis”, although it is often referred to as “ketamine bladder”.
Is ketamine infusion safe?
When administered by a physician in a medical setting, ketamine infusions are rarely associated with serious adverse events. In one study, the most commonly reported side effect of ketamine infusions was psychological distress during treatment. Additional serious adverse events may include vomiting, seizures, high blood pressure, and bladder problems. Panic attacks, mood swings, and hallucinations are also reported to occur in individuals who receive ketamine infusions.
Is ketamine safe to use during pregnancy?
Ketamine is used as an anesthetic during cesarean section and may also help prevent postpartum depression when given during cesarean section. While these uses of ketamine are unlikely to result in fetal harm, chronic or repeated use of ketamine during pregnancy may lead to fetal brain damage. The routine use of ketamine during pregnancy is generally not recommended.
Can ketamine treat depression?
Ketamine affects the activity of NMDA, a chemical in the brain that is associated with depression. In animal studies, administration of drugs that blocked the activity of NMDA were effective in the treatment of depression, leading to the question of whether these drugs could also have beneficial effects in humans who suffer from depression. Human studies of ketamine in depressed individuals have been conducted since the year 2000. These studies suggest that ketamine (or its derivative, esketamine) may have beneficial effects when administered to people with treatment-resistant depression (depression that has persisted despite the use of at least two other antidepressant medications). Ketamine is not currently approved by the United States Food and Drug Administration (FDA) as a treatment for depression, but in 2019, Spravato® (esketamine) was approved by the for use in individuals with treatment-resistant or severe depression. Because Spravato is associated with severe risks, including excessive sleepiness, behavioral changes, and drug dependence, it should only be administered in a healthcare setting by a certified physician.
Is ketamine a drug of abuse?
Because of its anesthetic and euphoric effects, ketamine is recognized as a drug of abuse in the United States and other countries. Ketamine is a common “club drug” used at raves and dance parties worldwide. As a non-narcotic, legal prescription drug, ketamine is often less expensive and easier to obtain than other “club drugs” such as ecstasy or methamphetamine. In some countries, ketamine is taken at raves in in combination with ecstasy and cannabis. This combination of drugs is sometimes described as a “trinity”.
How addictive is ketamine?
Due to its anesthetic properties and ability to cause euphoria, ketamine is associated with dependence and addiction. Ketamine acts on chemicals in the brain, including dopamine, which are involved in the development of addiction. In animal studies, a single dose of ketamine affected dopamine levels in the brain, suggesting that even short-term use of ketamine may increase the risk of drug dependence. Ketamine abuse and misuse are also associated with withdrawal symptoms. People who abruptly discontinue ketamine often report experiencing fatigue, loss of appetite, drowsiness, anxiety, mood swings, sweating, and palpitations.
What should I do if I get sick after using ketamine?
If you develop unexplained or unexpected symptoms after using ketamine, get guidance from Poison Control immediately. Help from Poison Control is available at online or by phone at 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.
Kelly Johnson-Arbor, MD
Medical Toxicologist
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Suggested page citation (APA):
Johnson-Arbor, K. (n.d.). What is ketamine?. Poison Control. https://www.poison.org/articles/ketamine
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Only take medications that are prescribed for you by a medical professional.
- Tell your doctor about unexpected signs or symptoms that you experience after ketamine administration.
- If you are pregnant or trying to become pregnant, do not use ketamine unless advised to do so by a physician.
This Really Happened
A 25-year-old man experienced frequent and painful urination, as well as the passage of bloody urine, for two years. Testing of his urine did not reveal the presence of infection, and laboratory tests of his kidney function were within normal limits. His symptoms persisted despite treatment with antibiotics. He was referred to a kidney specialist, who inserted a tube into his bladder and discovered that the bladder was inflamed and swollen. The patient subsequently admitted that he had used ketamine recreationally for four years. He was diagnosed with ulcerative cystitis. He was treated with medications to reduce bladder inflammation and eventually underwent surgery to repair his damaged bladder tissue (from Chiew et al, 2009).
For More Information
Ketamine for treatment-resistant depression: When and where is it safe? - Harvard Health Blog
References
Poisoned?
Call 1-800-222-1222 or
Prevention Tips
- Only take medications that are prescribed for you by a medical professional.
- Tell your doctor about unexpected signs or symptoms that you experience after ketamine administration.
- If you are pregnant or trying to become pregnant, do not use ketamine unless advised to do so by a physician.
This Really Happened
A 25-year-old man experienced frequent and painful urination, as well as the passage of bloody urine, for two years. Testing of his urine did not reveal the presence of infection, and laboratory tests of his kidney function were within normal limits. His symptoms persisted despite treatment with antibiotics. He was referred to a kidney specialist, who inserted a tube into his bladder and discovered that the bladder was inflamed and swollen. The patient subsequently admitted that he had used ketamine recreationally for four years. He was diagnosed with ulcerative cystitis. He was treated with medications to reduce bladder inflammation and eventually underwent surgery to repair his damaged bladder tissue (from Chiew et al, 2009).