A 2018 review has shown ketamine may also be effective for treating substance use disorders, such as alcohol, cocaine, or opioid use disorder. But its benefits, dosages, and safety for long-term use need further research. Before Spravato was approved in 2019, ketamine was prescribed off-label for the treatment of depression. Other off-label uses of ketamine include treating bipolar disorder, post-traumatic stress disorder, as well as substance use disorder. While taking an antidepressant or going to psychological counseling (psychotherapy) may work for most people, these standard treatments aren’t enough for others. Symptoms may not improve much or at all, or they may improve but keep coming back.
We strive to create content that is clear, concise, and easy to understand. Ketamine makes people feel detached from their environment, eases pain, and produces hallucinations, which has led to its inappropriate use. Because several other trials indicate ketamine may have significant antianxiety effects, the authors encouraged future studies to explore this possible benefit more fully. The FDA has approved ketamine for general anesthesia only, but the drug has some off-label uses. General anesthesia denotes a sleep-like state, while dissociative refers to the effect of feeling disconnected.
Some people just sleep off lower doses of ketamine, but others may continue experiencing a sense of derealization the day after taking it, especially at high doses. Ketamine hangovers can also include “dizziness, incoordination, [and] impaired attention and memory,” according to Masand. Other not entirely pleasant effects of ketamine can include anxiety, dizziness, or loss of balance. Patients often don’t enjoy the experience, and make comments like “time is going slowly” or “I feel a bit sunken in my chair,” Masand said. This means that it produces sedative effects but also produces cognitive effects that include memory loss (amnesia) and feeling as if one is detached from oneself or reality. Addiction to substances such as ketamine is characterized by an inability to stop despite negative consequences, preoccupation with the substance, and disruptions that interfere with important aspects of life.
- Animal studies suggest that neurodegeneration, with possible cognitive sequelae, is a potential long-term risk of anesthetics in neonatal and young pediatric patients23.
- Additionally, ketamine has been abused to facilitate sexual assault.
- We’ll be examining the symptoms to look out for, and factors that can increase the risk of developing a dependence or addiction to ketamine.
- While the current literature provides evidence for acute relief of chronic neuropathic pain, evidence supporting the efficacy and tolerability of ketamine for the long-term treatment of chronic pain is still limited.
- They continue to take their antidepressant pill and receive esketamine at a certified doctor’s office or in a clinic, where a health care provider watches over them for at least 2 hours after the dose.
Ketamine is most often obtained in powder form and most often misused by snorting or inhaling it. The drug is also not suitable for individuals with schizophrenia or who are pregnant or breastfeeding. Evidence shows that ketamine is safe for use in people within a wide age range when taken correctly.
Signs of Ketamine Misuse
I analyzed my life as if I were in therapy, suddenly seeing the perspectives of people I was mad at. In contrast, no recreational use of the drug is safe, as it can cause addiction and adverse health effects that can lead to death. Some studies suggest the drug may have other medical uses, but more research is necessary to prove its safety and effectiveness in these areas. 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, some people use it as a date-rape drug.
One of ketamine’s positive features is that it has a minimal effect on the central respiratory drive if given slowly, although rapid iv injection can cause transient apnea. Ketamine increases salivary secretions, which may increase the incidence of laryngospasm. This may be due to partial airway obstruction and can be resolved by simple airway maneuvers. Secretions can be anticipated; therefore, it is recommended to co-administer a small dose of atropine (0.01 mg/kg)22. Ketamine can be dangerous, particularly when combined with other substances. It is largely non-fatal when used alone—there is little on record of a lethal dose of this drug in humans.
If you have certain health conditions, such as high blood pressure or heart-related problems, or certain mental health conditions, such as schizophrenia, ketamine may not be safe for you. Your doctor can tell you about the latest research and medical uses for ketamine, including the pros and cons of the drug. Off-label use means that your physician is using the drug for a purpose other than its approved use in anesthesia.
Treating depression
The findings of one meta-analysis added to the existing evidence that support ketamine as a novel treatment option for depression, stating that ketamine has been shown to have a high response rate and rapid effect87. A systematic review also showed ketamine to be a rapid and effective treatment option for depression, as well as reducing suicidal ideation, with minimal short-term side effects90. Furthermore, evidence reported in the literature from studies with single and multiple doses of ketamine also showed that some subjects might be able to sustain the response for weeks to months91,92. Studies to date suggest intravenous ketamine produces substantial reductions in suicidal ideation in patients with unipolar and bipolar depression, in both uncontrolled and randomized controlled trials. Large reductions have been observed in as early as 40 min post-infusion, with improvements maintained for variable amounts of time ranging from 230 min up to 10 d post-infusion93. Price and colleagues94 conducted a randomized controlled trial in treatment-resistant depression, which showed that intravenous ketamine produces rapid reductions in suicidal cognition over and above active placebo.
Rehabilitation centers can help with different treatment options, detox programs, and other necessary assistance for overcoming dependency. Ketamine is a drug gaining fast notoriety with America’s young population. In 2020, 1.3% of 12th graders were found to have misused the drug for recreational purposes—this number was at 0.7% only hypertension a year prior. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available. Additionally, ketamine has been abused to facilitate sexual assault. Ketamine is also used for anesthesia in a range of veterinary procedures, such as for dogs, cats, and other animals.
Giordano also warned against taking ketamine more than once in one sitting. People may feel tempted, since the effects wear off fairly quickly, but the effects of multiple doses add up. There’s also a chance that ketamine obtained outside medical clinics could be laced with other drugs—there have been reports in Australia of ketamine laced with opioids.
Why Do People Take Ketamine?
It is classified as a Schedule III non-narcotic substance in the United States and is illegal without a prescription. The initial IV dose of Ketalar ranges from 1 milligram (mg) per kilogram (kg) of body weight to 4.5 mg per kg of body weight. The initial dose for anesthesia induction is administered over several minutes. Ketamine can be administered alcohol and drug detox treatment blog during abdominal operations, orthopedic procedures, surgical burn treatment, some dental procedures, and many other types of surgery. This medication is used for different types of anesthesia, including general anesthesia and spinal anesthesia. It can have effects within seconds, and the effects wear off within 15 to 20 minutes.
The spreading and tapering of treatments over time should help reduce this risk. Over the past decade or so, legal ketamine clinics have popped up to treat depression, OCD, and other mental health conditions. “It has literally saved lives for people who were ready to give up all hope,” Masand said.
Because of the favorable cardiovascular characteristics, stimulating the central sympathetic system and inhibiting neuronal catecholamine uptake, ketamine is preferred in patients with unstable hemodynamics. Ketamine is also one of the very few drugs approved for anesthesia induction in caesarean sections. It is considered the agent of choice in children and burn victims30. Additionally, administration of ketamine during induction, at least in patients with cardiopulmonary bypass, may attenuate post-operative delirium31.
It has also been implicated for the treatment of psychotic symptoms in schizophrenia, treatment of depression, and treatment of addiction—although ketamine itself is a commonly misused drug. Ketamine, a drug available in intravenous (IV) and nasal spray (esketamine) forms, is being actively alcoholic eyes studied for TRD treatment. Both ketamine and esketamine are given in a doctor’s office or a clinic, and each is typically used alongside another antidepressant. “It may not matter, but it does concern me, personally, that ketamine works through an opioid mechanism,” he says.