Overview of K.

What is ketamine?

Originally an anesthetic used for pain during surgical operations, ketamine has demonstrated the potential to change how practitioners address treatment-resistant depression and other conditions for which conventional medicines have failed to offer adequate relief of symptoms.

Ketamine shows impressive potential for relief of mental health issues, like suicidality and treatment-resistant depression. Research continues to explore further possibilities.

Additionally, people use ketamine to assist them on their paths of personal exploration—setting intentions to connect with a higher purpose—often to make sense of their sources of suffering.

Ketamine is also commonly used as a recreational drug but is legal only with a prescription.

How does ketamine work?

In cases where ketamine is used to bolster existing treatment strategies that haven’t shown sufficient results, it offers a different approach to addressing mental health issues. While many psychiatric medications focus on regulating neurotransmitters such as norepinephrine, dopamine, and serotonin, ketamine works with the neurotransmitter glutamate.

Ketamine also increases a protein called brain-derived neurotrophic factor. This protein enhances neural plasticity and helps create new thought and behavioral patterns when individuals feel “stuck.” When ketamine is used in conjunction with psychotherapy clients more quickly identify and challenge disillusioned beliefs. From here, they are able to develop new ways of thinking which lead to rapid symptom resolution.

Only recently has research demonstrated a link between levels of glutamate in the brain and mood regulation. It is also possible that ketamine helps reduce inflammation related to cognition, but there is still more to learn before that can be verified.

Intake methods and effects

Ketamine has several different methods of intake. How ketamine is taken depends on the purpose—and dosage can vary accordingly. The characteristic effects are similar to the different methods of intake, but each has the potential to yield a unique experience, based on the individual, and other variables.

How does ketamine feel?

In general, ketamine can make a person feel dissociated from themselves or reality. This is sometimes considered a benefit, as it might provide the opportunity for more productive therapy sessions while processing difficult traumatic experiences (like in cases of post-traumatic stress disorder (PTSD).

Other possible effects can include a feeling of transcendence that allows a person to reflect more objectively on their lives, connect more deeply with themselves, or experience a sense of greater meaning. Ketamine might also intensify, enhance, or alter the appearance of colors, shapes, and sounds in one’s surroundings.

Ketamine can enhance a person’s feelings of dissociation. Dissociation can be unnerving for some people, particularly in cases of high dosage or a response that results in uncomfortable experiences involving hallucinations, anxiety, and psychosis. Dizziness can also occur, or the sensation of being stuck in one place.

For ketamine ingested orally (the clinical term for ketamine lozenges is a troche), users often report feeling numbness or tingling in their mouth and tongue. They also may report slight feelings of dizziness at the initial onset.

To minimize the likelihood of a negative response to ketamine, it should be taken under the guidance of a knowledgeable practitioner who can guide and supervise a ketamine experience.

For a comprehensive description of physical and psychological side effects, read our Beginner’s Guide to Ketamine.

How to Consume Ketamine:

 Here are the known intake methods and what can usually be expected in terms of effect.

 Drip or intravenous infusion

 It is common for ketamine to be administered at a clinic by way of infusion treatments, also called an IV (intravenous) drip. In this method, the medicine bypasses the digestive system and directly enters the bloodstream.

 For infusion treatments, a person typically receives ketamine in a limited series of sessions, with a period of supervision after each completed session which ensures patient safety. Even though the acute effects may fade within an hour or two, it can take the rest of the day (sometimes longer) to safely drive a car or operate machinery.

 Ketamine infusions occur as one part of a comprehensive therapy plan, which involves psychotherapy and (frequently) other psychiatric medications that may be needed.

 Injections or intramuscular shots

 An intramuscular injection of ketamine is a shot administered to the muscle tissue. The onset of effects can happen more quickly, and the treatment itself takes much less time than an infusion treatment (which can take about 40 minutes or longer). This might help increase the accessibility of ketamine to people for whom infusion treatments are not an option.

 Nasal inhaler

 Ketamine is available in a nasal spray or inhaler in both generic versions and in a version called Spravato. Spravato has been FDA-approved for the treatment of major depression when typical antidepressants have not been effective, and for acute treatment during the period of time it takes to see effects after first starting a medication.

 With Spravato, a person administers the medicine themselves under the supervision of a practitioner and stays in their care for a period of supervision. Operation of a vehicle or machinery, as well as other functions requiring uncompromised awareness of safety, should be avoided until the next day.

 Oral intake

 Ketamine is also available in the form of an oral lozenge called a troche, which takes the longest for the onset of effects. The lozenges are dissolved in the mouth and absorbed in the mucosa membranes of the mouth and tongue. The lozenge either remains under the tongue or when it is dissolved, a person “swishes” the dissolved lozenge in their mouth as it mixes with saliva. Then they swallow the solution after a period of time as directed by the prescriber (5-15 minutes).

 It can also be taken as an extended-release tablet, which research has found may help people avoid or minimize long periods of dissociation.

 These lozenges can be prescribed by a primary care physician, psychiatrist, or someone licensed to prescribe such as a psychiatric nurse practitioner. Taking ketamine orally may be less bioavailable than other methods, but can be a more affordable option. Depending on the severity of the patient’s symptoms, sometimes prescribers suggest lozenges in addition to an IV infusion, or injection treatments.

 Other Intake methods

 Ketamine comes in 2 forms: powder and colorless liquid. The other known methods of intake are by snorting the powder or ingesting the liquid orally (as is or mixed into a beverage), however, there is no documented use of these techniques in official trials related to therapy and are associated with personal or recreational use.

Usual Adult Dose for Anesthesia (ket@mine)

IV:

  • Induction: 1 to 4.5 mg/kg IV; alternatively, 1 to 2 mg/kg IV at a rate of 0.5 mg/kg/min; (2 mg/kg dose provides 5 to 10 minutes of surgical anesthesia within 30 seconds)
  • Maintenance: The maintenance dose should be adjusted according to the patient’s anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.


IM:

  • Induction: 6.5 to 13 mg/kg IM; (9 to 13 mg/kg IM provides 12 to 25 minutes of surgical anesthesia)
  • Maintenance: The maintenance dose should be adjusted according to the patient’s anesthetic needs and whether an additional anesthetic is employed. Increments of one-half to the full induction dose may be repeated as needed for maintenance of anesthesia.

 Where can I get ketamine?

 Ketamine must be obtained and provided by a practitioner who has a license for use in therapeutic practice. Producing it at home or obtaining it other than from a practitioner is illegal.

Also, without the guidance of an experienced guide, a person who opts to use ketamine without direction from a licensed practitioner risks dangerous health complications, dependency, and possible addiction.

Ketamine is intended to be combined with other therapeutic modalities to achieve optimal success and long-term best outcomes.

 Safety and precautions

 Ketamine has been determined to be safe as a part of treatment for those with non-psychotic psychiatric needs for healthy adults. It should not be used by anyone with a history of or potential to develop psychosis. It is not intended for recreational or unsupervised use, can be dangerous if misused, and is not legal for those purposes.

 If ketamine seems like the right fit for addressing your mental health and personal therapeutic needs, it is important to locate a licensed and competent practitioner who can create an appropriate treatment plan for you.

 How to Take Ketamine Faqs:

 Are Ketamine Troches Addictive?

 Ketamine troches, like other forms of ketamine, have the potential for addiction and abuse. While they are prescribed for specific medical purposes under supervision, misuse or overuse can lead to addiction. Always follow your healthcare provider’s instructions and use ketamine only as prescribed.

 Can You Take Ketamine Troche on an Empty Stomach?

 It’s generally recommended to take ketamine troches on an empty stomach. This can help with absorption and reduce the likelihood of nausea, which is a common side effect. However, follow your healthcare provider’s specific instructions regarding dosing and food restrictions.

 How Is Ketamine Ingested?

Ketamine can be ingested in various ways. It is commonly administered intravenously (IV) in medical settings. Ketamine can also be taken orally in the form of pills, capsules, or troches (lozenges). Additionally, some people misuse ketamine by snorting or inhaling it, which is not safe and can lead to serious health risks.

 How to Take Sublingual Ketamine?

To take sublingual ketamine, place the ketamine troche under your tongue and allow it to dissolve completely. This method allows for quicker absorption through the mucous membranes under the tongue, leading to a faster onset of effects compared to oral ingestion.

 What Is the Best Way of Taking Ketamine?

The best way to take ketamine depends on your specific medical condition and the guidance of a healthcare professional. Ketamine should only be used as prescribed by a healthcare provider. The appropriate method of administration (intravenous, oral, or sublingual) will be determined based on your individual needs and the purpose of the treatment. Misusing ketamine for recreational purposes is not safe and can have serious health consequences.

 Therapeutic uses of ketamine

The FDA has approved ketamine for general anesthesia only, but the drug has some off-label uses. Details are below.

Inducing general anesthesia

Doctors use ketamine to induce general anesthesia alone or with other general anesthetics, such as nitrous oxide. They use it in the emergency department setting to produce short-term sedation whenTrusted Source:

  • reducing fractures
  • treating joint dislocations
  • repairing wounds in uncooperative individuals, such as children

Treating pain

Practitioners use low doses that do not produce dissociation to relieve severe pain from the followingTrusted Source conditions:

  • trauma
  • fractures
  • abdominal pain
  • arm or leg pain
  • low back pain

Treating status epilepticus

Status epilepticus is when a person has a seizure that lasts longer than 5 minutes or has more than one seizure within 5 minutes.

Refractory status epilepticus (RSE) is a form of status epilepticus that does not respond to standard antiseizure drugs. It is a severe disease that can cause brain damage and death.

Treating depression

Research has found that ketamine can quickly relieve depression in people who do not respond well to other treatment.

The authors of a 2023 review of studies suggested that the type of ketamine and the right dose are key factors influencing how well it works as a treatment for depression. They also noted that higher doses of ketamine appear to help reduce depression symptoms at all stages of treatment.

Treating anxiety

Research into the use of ketamine for anxiety is scarce, but there is evidence that it has fast-acting, anxiety-relieving effects. A 2022 review noted that studies use such varied protocols for treating anxiety with ketamine that it is difficult to draw clear conclusions about its effects.

However, the authors did highlight that the anxiety-relieving effects of ketamine are temporary, with symptoms often returning around 2 weeks after taking it.

More research into treating anxiety with ketamine is necessary.

The side effects of ketamine

The most commonTrusted Source side effects of ketamine at prescribed doses include:

  • drowsiness
  • double vision
  • confusion
  • nausea
  • vomiting
  • dizziness
  • a feeling of unease

Ketamine can also produce an extensive array of other symptoms that affect many parts of the body, but they are less common.

Evidence shows that ketamine is safe for use in people within a wide age rangeTrusted Source when taken correctly.

However, ketamine is only safe when a person takes the drug their doctor has prescribed for a specific purpose.

Despite the general safety, ketamine carries the following risks:

  • Instability of heart and blood vessel function: This may include a temporary increase in blood pressure and heart rate or a decrease in blood pressure and heart rate. Abnormal heart rhythms may also occur.
  • Respiratory depression: This can happen in an overdosage or if the rate of administration is rapid.
  • Emergence reactions: Such reactions include agitation or confusion within the postoperative recovery period.
  • Increase in intracranial pressure: Due to this effect, practitioners should closely monitor anyone with high intracranial pressure.
  • Liver injury: The administration of ketamine may cause liver dysfunction.
  • Cognitive, or thinking, deficits: Some research reports that these effects occur in children.

Doctors do not recommend ketamine for people of any age who have conditions in which high blood pressure could lead to:

The drug is also not suitable for individuals with schizophrenia or who are pregnant or breastfeeding.Coming down from ketamine

The day after taking ketamine, a person may experience the following:

  • disorientation
  • aches and pains
  • impaired judgment
  • anxiety
  • clumsiness

Ketamine makes people feel detached from their environment, eases pain, and produces hallucinations, which has led to its inappropriate use.

Individuals who take ketamine recreationally report sensations, such as being separated from their body or a pleasant feeling of floating. Some people have an almost complete sensory detachment that they compare to a near-death experience.

The drug is popular among teens and young adults at dance clubs. People who use it claim that a ketamine trip is superior to a PCP or LSD trip because it produces shorter-term hallucinations that last 30 minutes to an hour instead of several hours.

Ketamine also causes individuals to have no memory of events that happen while they are under its influence. Due to this effect and its ability to sedate and incapacitate people, rapists may use it as a date-rape drug. Perpetrators who use it in this manner may slip it into a beverage of the person they wish to victimize. Because it is odorless and tasteless, a person cannot detect it.

Street names of ketamine include:

  • Cat tranquilizer
  • Jet K
  • Cat valium
  • Purple
  • Kit Kat
  • Special La Coke
  • Super K
  • Special K
  • Super acid
  • Vitamin K

It is important to note that ketamine is no longer safe when individuals take it inappropriately. The danger increases with regular use since it can harm health and other aspects of life. The side effects and risks can be so severe that they cause death.

Ketamine and alcohol

No person with alcohol use disorder or alcohol intoxication should take ketamine, even in doctor-prescribed doses, as it can causeTrusted Source death. Both alcohol and ketamine are central nervous system depressants, so the combined effects are dangerous.

Ketamine and other drugs

The following adverse drug interactions are possible:

  • Theophylline (Theo 24) or aminophylline (Norphyl): These drugs treat airway obstruction in people with asthma and chronic obstructive pulmonary disease. Taking one of them together with ketamine may lower the threshold for seizures, which would increase their risk.
  • Vasopressin (Vasostrict): This class of drugs constricts blood vessels and helps treat low blood pressure. Because ketamine also has this effect, a doctor should prescribe a lower dose to avoid the dangers of too much blood vessel constriction.
  • Central nervous system (CNS) depressants: The CNS consists of the brain and spinal cord. Drugs that suppress CNS action include benzodiazepines, which are antianxiety medications, such as diazepam (Valium), or opioid pain relievers, such as oxycodone (OxyContin). Taking one of these with ketamine may result in profound sedation, coma, and death.

Overdose

One of the dangers of ketamine overdose involves a higher risk of accidents and injuries due to impaired alertness. High doses can also cause death that stems from their physical effects.

If an individual experiences any of the following symptoms, a bystander should call 911 to get immediate medical attention:

The Controlled Substance Act classifies ketamine as a Schedule III non-narcotic drug. Because of its pain-relieving and mental effects, it can cause dependence, the need to take higher doses to get the same effect, and addiction.

Like any other addiction, ketamine can create a powerful bond that takes control of a person’s life. It is critically important that an individual who engages in inappropriate use of ketamine get professional counseling and treatment.

Help is available

Seeking help for addiction may feel daunting or even scary, but several organizations can provide support.

If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice.

Ketamine is a general anesthetic that doctors use in emergency room settings to perform procedures such as reducing fractures and treating joint dislocations.

Some studies suggest the drug may have other medical uses, but more research is necessary to prove its safety and effectiveness in these areas.

It is important to distinguish between the valid medical uses and the nonmedical uses of the drug. Although people with certain heart conditions should not take ketamine, it is generally safe when a trained professional administers it in clinical settings.

In contrast, no recreational use of the drug is safe, as it can cause addiction and adverse health effects that can lead to death.