If you’ve ever had a general anesthetic, you may have heard of ketamine. The commercial use of ketamine began in the 1970s, and it’s now commonly used for various clinical applications, including anesthesia, palliative care, and, most recently, for the treatment of depression. Ketamine is also well known for being a "recreational" drug on the party scene, and it has the potential for abuse.
What Is Ketamine?
Ketamine’s chemical makeup is similar to phencyclidine (PCP), nitrous oxide, and dextromethorphan (DXM). It’s been widely used as an anesthetic for surgery in both humans and animals. Street names for ketamine are VitaminK, Super K, K, Green and Donkey Dust.
What are the Effects of Ketamine?
Ketamine provides complete sensory detachment and produces hallucinogenic-like effects. It is a dissociative drug with sedating effects and may cause numbness, memory loss, and unconsciousness while maintaining respiratory reflexes and adequate blood pressure.
Ketamine has a psychedelic effect and may reduce overall body sensations. It produces an abrupt high that lasts for about one or two hours. The immediate effects of ketamine may include drowsiness, profuse sweating, an irregular heartbeat, confusion, nausea, numbness, and slurred speech. It may also create an overwhelming feeling of relaxation, and consumers may feel "out of their bodies" or a dream-like detachment. Ketamine can alter a person’s sense of space and time and cause visual or auditory hallucinations.
Continued ketamine use causes a slow heartbeat, elevated blood pressure, behavioral changes, and difficulty breathing. Heavy ketamine use results in urinary tract problems as it may thicken the bladder wall, causing pain during urination. Prolonged use may also cause agitation, panic attacks, and reduction of long-term and short-term memory.
Too much ketamine may cause immobility and a sense of going into "k-hole," an intense feeling of separating from one’s body. Withdrawal from prolonged ketamine abuse comes with numerous side effects such as depression, anxiety, lack of appetite, insomnia, and restlessness. It is possible to become addicted to ketamine, and with abuse, more may be needed to feel its effects.
When used correctly, ketamine has numerous therapeutic benefits, including the following:
Treatment of Depression with Ketamine
The FDA recently approved ketamine for "off-label" consumption, and clinics across the United States are using it to treat depression. Recent studies indicate that up to 70% of patients treated with treatment-resistant depression improved when given an oral antidepressant with intranasal esketamine, a nasal spray derived from ketamine.
It’s believed that ketamine works for depression as it enhances the transmission of gamma-aminobutyric acid (GABA) and triggers glutamate production. In turn, this prompts the brain to create new neural connections. As new bonds form, patients can approach life with more positive associations and behaviors. Ketamine works quickly in treating depression and anxiety, whereas traditional antidepressants may take weeks to take effect, if at all.
Ketamine infusions for depression usually take effect within four to seventy-two hours, and patients may feel a lasting impact for 1-3 weeks. Anecdotal reports also indicate ketamine may be a potential treatment for obsessive-compulsive disorder, post-traumatic stress disorder (PTSD) and other neuropsychiatric disorders.
Chronic Pain Relief with Ketamine
Ketamine is frequently an effective treatment for chronic pain, neuropathic pain, and fibromyalgia. Low-dose ketamine infusions have had a beneficial effect on the central nervous system, effectively rebooting neurotransmitters within the brain. Patients may feel immediate and sustained relief from pain through a series of low-dose ketamine infusions.
While surgical operations tend to be very painful, ketamine relieves acute pain significantly. When your nerves send those pain signals to the brain, ketamine cuts them off. You won’t feel the excruciating pain after some surgical blades have cut through your body organs. Vietnam War soldiers used these psychedelics to relieve pain from injuries.
What are the Risks Associated With Ketamine?
Consumption of ketamine within a clinical setting is considered relatively safe. Some patients may feel uncomfortable with the associated effects, such as feeling disassociated from the body or a sense of "couch-lock."
Ketamine may cause an increase in blood pressure. People who have the following are not candidates for ketamine treatment:
- brain lesions or tumors
- brain swelling
There are several other conditions where ketamine treatments should be used with caution.
Is Ketamine Legal?
The FDA has approved nasal-spray esketamine for the treatment of depression. It’s legal in specific states but each state has individual regulations on the administration of ketamine. Utah and Texas, for example, have legalized medicinal use of the drug, whereas other states such as California, Delaware, and Wyoming, among others, have placed ketamine as a Schedule III.
Ketamine Drug Interactions
Ketamine has seven significant drug interactions and two hundred and fifty-six moderate drug interactions. It is essential to check with a physician to determine how ketamine may interact with any medications currently in use.
Where Can I Legally Seek Ketamine Treatment?
More than 150 clinics in the US offer various forms of ketamine treatment. With the legalization of ketamine spray and infusions, new clinics continue to open. While it might not be easy to find a ketamine cline, there are many established providers in legalized states. When looking for a ketamine clinic, conduct due diligence, and check with your local healthcare provider.
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