What is Ketamine and Who Should Use it?

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Ketamine is a remarkable substance that can transform mental health and wellness. Often associated with anesthesia and party scenes, ketamine is now emerging as a potential game-changer for mood, pain, and sleep disorders. In this article, we’ll explore the science behind ketamine, its benefits, and how it’s revolutionizing mental health care.

What is Ketamine? 

According to the U.S. Drug Enforcement Administration (DEA), ketamine is a “dissociative anesthetic that has some hallucinogenic effects.” In the medical field, it’s a preferred sedation medication because of its low risk of respiratory depression. In other words, it sedates patients without creating airway spasms.  Even so, healthcare professionals often give ketamine with other general anesthetics, like nitrous oxide (“laughing gas”). 

Ketamine comes in a few different forms. It can be given via intramuscular injection, intravenous infusion (IV-form), orally, or intranasal spray. Intranasal formulations are a convenient and accessible option. This way patients can give it to themselves while under medical supervision. It widens access to ketamine therapy and makes it accessible for those who may not have a ketamine clinic nearby.

Ketamine goes by different nicknames on the street. Examples include “Special K,” “Super K,” “Kit Kat,” and even “Vitamin K.” Those who use it recreationally claim a ketamine trip is better than PCP (Phencyclidine) or LSD. They say it’s because the hallucinations don’t last very long, only 30 to 60 minutes rather than several hours. 

Recently, the field of psychiatry began promoting ketamine for certain mental health conditions. At specialized infusion centers, medical professionals carefully watch patients during each session to ensure their well-being. They also make sure the treatment is tailored to each individual’s needs. Infusion therapy usually involves a series of sessions spread over a few weeks, with follow-up sessions to maintain the benefits. 

Those experiencing depression, anxiety, OCD, and PTSD are some who may benefit from ketamine.

How Does Ketamine Work?

Ketamine mainly works by blocking the NMDA receptor pores in the brain. It blocks glutamate from binding to these receptors and enhances glutamate levels. This neurotransmitter plays a crucial role in the formation of new neural connections. That means it can make new pathways in the brain.

Ketamine may also work on the opioid receptors through its interactions with glutamate. By blocking the NMDA receptors, ketamine increases opioids (think morphine) throughout the body. These opioids can bind to and activate opioid receptors, leading to pain-relieving effects.

Uses of Ketamine

Originally developed as an anesthetic in the 1960s, ketamine was designed to alter neurotransmitter activity. Unlike traditional antidepressants, which may take weeks to produce effects, ketamine is very fast. Before long, patients find it alleviates symptoms of depression, anxiety, and 

even PTSD.

Depression and Anxiety

Ketamine also has antidepressant effects and is used for treatment-resistant depression and anxiety. Studies show it can quickly reduce symptoms of depression and anxiety when other treatments have failed.

Its fast-acting response can be particularly beneficial for those who are so depressed they’ve have lost the will to live. It can rapidly give them a chance to regain control over their lives. In fact, some experts describe it as a “reset button” for the brain because it breaks negative thought patterns. In so doing, it also provides the opportunity to start fresh.

A form of ketamine called esketamine (Spravato) is the only version that is FDA-approved for depression. It’s in the form of a nasal spray and is given at a clinic, where a healthcare professional watches the patient for any adverse effects. Because ketamine for depression is considered an off-label use, health insurance won’t usually cover it for this purpose. 

Chronic Pain 

Ketamine may also provide some relief for acute and chronic pain, including conditions like fibromyalgia. As mentioned above, ketamine may lower pain by activating opioid receptors in the body, leading to a morphine-like effect. A 2020 review also suggested other receptors like AMPA might be involved in ketamine’s ability to reduce pain.

PTSD 

Ketamine has also shown promise in treating post-traumatic stress disorder (PTSD). By altering the fear response, ketamine may help patients process traumatic memories safely, reducing the emotional distress associated with past traumas. In a small review of randomized clinical studies, ketamine quickly and effectively improved PTSD symptoms.  

Obsessive Compulsive Disorder (OCD)

OCD is another condition that ketamine may improve. It’s still unknown exactly how ketamine helps OCD. However, it may work by acting as an NMDA receptor antagonist (blocker). Ketamine may help restore balance in glutamate signaling, which could help reduce OCD symptoms. Researchers found low doses were effective, and worked quickly. A 2022 systematic review confirmed ketamine’s “fast onset of action and good tolerability.”

Side Effects of Ketamine

It’s best to start ketamine with a lower dose until you know how your body will react. Other potential side effects of high doses of ketamine include: 

  • Increased heart rate
  • High blood pressure
  • Slurred speech
  • Confusion
  • Agitation or panic
  • Hallucinations
  • Flashbacks
  • Memory loss
  • Liver and urinary toxicity

Taking too much ketamine can temporarily cause a feeling of detachment from the body. Some people refer to this feeling as “falling into a K-hole.” Others describe it as feeling like a “near-death” experience.

Contraindications of Ketamine 

Ketamine isn’t for everyone with mental health conditions. Those with a history of psychosis, mania, or schizophrenia could worsen with ketamine treatment. Ketamine also affects blood pressure and heart rate. For that reason, those with high blood pressure or heart conditions should check with a doctor first.

Additionally, it’s important to note that ketamine is metabolized in the liver and excreted by the kidneys. Anyone with compromised liver or kidneys should check with their doctor before trying ketamine. They may need a low dose rather than the full-strength version. The same goes for those with glaucoma, as ketamine can increase pressure in the eyes.

Mixing ketamine with alcohol or drugs like benzodiazepines or opiates can be dangerous. Taking ketamine with any other meds must be done under the supervision of a medical doctor, as it may cause even more adverse effects. Those struggling with addictions should also be closely monitored during ketamine therapy.

It also goes without saying that anyone with allergies to ketamine or any of its constituents shouldn’t take ketamine. Doing so could do more harm than good.

Final Thoughts on Ketamine

While ketamine shows great promise, it should always be used under medical supervision. Self-administration or recreational use of ketamine can lead to adverse effects. 

Personally, psychedelic assisted therapy was a big part of my healing experience in overcoming my PTSD and autoimmune disease. They’re not for everyone though in every situation. If you’re interested in trying ketamine it’s best to find a healthcare professional to guide you through the process. This way you can make informed decisions when it comes to your physical and mental health journey.  

I’ve had several podcast guests who’ve discussed ketamine therapy and psychedelic medicine. You can listen to those episodes here:

Have you, or anyone you know, tried ketamine for these conditions? Was it helpful? Share with us below!

Sources

  1. United States Drug Enforcement Administration. Ketamine. DEA website.
  2. Rosenbaum SB, Gupta V, Patel P, et al. Ketamine. [Updated 2022 Nov 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  3. Liu, X. B., Zhang, Y., Wang, X. Y., & Hao, W. (2017). The synergistic effect of dual use of amphetamine-type stimulants and ketamine on drug-induced psychotic symptoms in Chinese synthetic drug users. Oncotarget, 8(39), 66569–66575.
  4. Drugs.com. (2023). Ketamine: Uses, Effects, Hazards & Overdose. Drugs.com website.
  5. Noppers, I., Niesters, M., Aarts, L., Smith, T., Sarton, E., & Dahan, A. (2010). Ketamine for the treatment of chronic non-cancer pain. Expert opinion on pharmacotherapy, 11(14), 2417–2429.
  6. Barrett, W., Buxhoeveden, M., & Dhillon, S. (2020). Ketamine: a versatile tool for anesthesia and analgesia. Current opinion in anaesthesiology, 33(5), 633–638.
  7. Yang, Y., Maher, D. P., & Cohen, S. P. (2020). Emerging concepts on the use of ketamine for chronic pain. Expert review of clinical pharmacology, 13(2), 135–146.
  8. Waldfogel, J. M., Nesbit, S., Cohen, S. P., & Dy, S. M. (2016). Successful Treatment of Opioid-Refractory Cancer Pain with Short-Course, Low-Dose Ketamine. Journal of pain & palliative care pharmacotherapy, 30(4), 294–297.
  9. McIntyre, R. S., Rosenblat, J. D., Nemeroff, C. B.,et al. (2021). Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation. The American journal of psychiatry, 178(5), 383–399.
  10. Tully, J. L., Dahlén, A. D., Haggarty, C. J., Schiöth, H. B., & Brooks, S. (2022). Ketamine treatment for refractory anxiety: A systematic review. British journal of clinical pharmacology, 88(10), 4412–4426.
  11.  Jumaili, W. A., Trivedi, C., Chao, T., Kubosumi, A., & Jain, S. (2022). The safety and efficacy of ketamine NMDA receptor blocker as a therapeutic intervention for PTSD review of a randomized clinical trial. Behavioural brain research, 424, 113804.
  12. Thompson, S. L., Welch, A. C., Iourinets, J., & Dulawa, S. C. (2020). Ketamine induces immediate and delayed alterations of OCD-like behavior. Psychopharmacology, 237(3), 627–638.
  13. Bandeira, I. D., Lins-Silva, D. H., Cavenaghi, V. B., et al. (2022). Ketamine in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review. Harvard review of psychiatry, 30(2), 135–145.

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Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

4 responses to “What is Ketamine and Who Should Use it?”

  1. manish Avatar

    I really Like your Article It Such an Informative and Helpful Article. Keep sharing.

  2. Karen G Avatar
    Karen G

    Therapist here. The mixed results of Ketamine are likely due to the lack of therapy before, during, and after the treatment. Therapy ASSISTED ketamine is showing results. As ALL medications for mental health symptoms are most effective with therapy.

  3. Lorri Freitas Avatar
    Lorri Freitas

    Ketamine has been a game changer for the extreme nerve pain my husband suffers from. He has a rare condition called adhesive arachnoiditis and it has progressed to the severe stage. So far, no other pain medication seem to work the same way for him. He takes it as a compounded oral syrup that costs about $90 for two weeks worth. It makes me crazy how difficult it is to find a doctor willing to prescribe it and how expensive it is for most people who can only get it infused. Hopefully this will get better in the future.

    Thank you, Katie, for all your wonderful content!

  4. Sandi Avatar

    I started doing Ketamine infusions in October 2022 to see if it would help with treatment resistant depression and chronic suicidality. I was running out of other things to try and was feeling pretty desperate. While a large percentage of people feel some relief within the first six infusions, it took me an additional four to begin to experience relief, but I’m glad I stuck with it. I had my infusions in a clinic, with a nurse present and monitoring my vitals the entire time. While ketamine is best knows as a street drug, it is used at a much lower dose for mental health. If you’ve had surgery, they may have used ketamine to anesthetize you. In that case, it is used at a much higher dose. That’s also how they first discovered it’s potential to help with mental health. It’s been studied since the 70’s when they realized that it’s use on soldiers for battlefield injuries lessened the likelihood that those soldiers would develop PTSD from the event where they were injured. It feel out of favor when its popularity took off as a street drug, but studies on it’s used for mental health began again some years ago, for which I’m thankful. I’m one of those people that can say that ketamine saved my life. I say this as a very holistically-minded person who tries to avoid pharmaceuticals as much as possible. My mental health isn’t perfect, but the ketamine was invaluable to help me get to a place where I can now do the work to heal from childhood trauma that caused the issues I was dealing with.

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