Ketamine: Effects, Medical Uses, Risks

Because ketamine cream does not reach the bloodstream in high concentrations, it is less likely to trigger the reinforcing effects that contribute to psychological dependence. Ketamine cream is a topical medication primarily used to treat chronic pain conditions, such as neuropathic pain, by applying it directly to the skin. As Morgan and Curran (2012) emphasize, the frequency of use and dosage are important factors in addiction potential. The addiction risk with nasal sprays, while lower than recreational use, still exists because of tolerance and the possibility of cravings.

The causes of ketamine addiction involve a mix of genetic, psychological, and environmental factors. However, its powerful dissociative effects make it prone to misuse, leading to dependency. However, even with medical oversight, prolonged use still results in psychological dependence, although the risk is considerably lower compared to recreational use. The way the drug is administered and absorbed limits its interaction with the brain’s reward system, which is a key factor in addiction.

Ketamine infusions are used for acute pain treatment in emergency departments and in the perioperative period for individuals with refractory or intractable pain. In particular, children with cyanotic heart disease and neuromuscular disorders are good candidates for ketamine anesthesia. A 2011 clinical practice guideline supports the use of ketamine as a sedative in emergency medicine, including during physically painful procedures.

Brain damage

Others used 0.2 grams of the drug several times per week, which is many times the recommended dose. The authors explain these effects could explain problems heavy users have with cognitive functions, such as memory. While in moderation, many use the drug without issues, excessive ketamine use can have severe and dangerous consequences. In fact, ketamine is one of the most popular recreational drugs in the world, and its use has grown considerably in the 2000s. Therapy is thought to help reinforce these new neurological connections and solidify the behaviors patients need to sustain positive changes over the long term. Having professional support helps sustain the benefits of ketamine treatment .

The “K-Hole” Experience

Bipolar affective disorder has a high rate of suicide as the consequence in about 6% of patients . This is because ketamine bypasses the serotonin pathway and directly leads to increased glutamate levels in the brain 83,84. Another study reported that ketamine’s antidepressive effect through the NMDARs is controversial . Ketamine in combination with propofol provided better effects in early recovery after gastrointestinal endoscopy . Ketamine given alone was reported to have side effects and is usually is combined with midazolam to prevent adverse effects and achieve the desired sedative effects . Different sedative medications have been studied for safe and effective use in young, uncooperative patients in pediatric dentistry.

Blood or plasma ketamine concentrations are usually in a range of 0.5–5.0 mg/L in persons receiving the drug therapeutically (during general anesthesia), 1–2 mg/L in those arrested for impaired driving, and 3–20 mg/L in victims of acute fatal overdosage. The more active enantiomer, esketamine (S-ketamine), is also available for medical use under the brand name Ketanest S, while the less active enantiomer, arketamine (R-ketamine), has never been marketed as an enantiopure drug for clinical use. In an experiment with purely ketamine anesthesia, people began to awaken once the plasma level of ketamine decreased to about 2,600 ng/mL (11 μM) and became oriented in place and time when the level was down to 1,000 ng/mL (4 μM). The typical intravenous antidepressant dosage of ketamine used to treat depression is low and results in maximal plasma concentrations of 70 to 200 ng/mL (0.29–0.84 μM).

Is Ketamine A Controlled Substance?

Acute toxic effects of ketamine include tachycardia, abdominal pain, hypertension, raised intracranial pressure, muscle rigidity, cognitive dysfunction, and sometimes death (2, 5). With a diagnosis of ketamine-induced multisystem illness, he was advised to refrain from further drug abuse and was discharged to a community-based drug rehabilitation program. We report a patient with chronic ketamine abuse who presented with severe cachexia, upper gastrointestinal involvement, hepatobiliary dysfunction, and acute kidney injury.

• Ketamine itself or its active metabolites were believed to cause injury to the urinary tract, although adulterants in the abused drug preparation were proposed as the cause by some authorities.
• According to Gold (2024), while ketamine misuse remains at 1% or less of the general population, its rising popularity among specific age groups makes it a serious public health concern.
• After absorption ketamine is rapidly distributed into the brain and other tissues.
• Evidence suggests that long-term CNS depression is likely the result of an interaction between ketamine and gabapentin 125,126.
• Research into the subanesthetic effects of ketamine, to understand both its therapeutic effects in MDD and its abuse potential, is growing at a high rate (Fig. 1).
• Most surgeries also require anesthetics that reduce muscle tone and movement.

Ketamine overdose may occur among people who abuse the drug. While ceasing ketamine drug use will not cause physical withdrawal symptoms, people may experience intense cravings due to psychological dependence. Some people who take ketamine in high doses may experience a near-death experience called a “k-hole”. Side effects of ketamine addiction may include psychological, behavioral, and physical symptoms.

Ketamine has been used in clinical trials to help treat people with cocaine and alcohol addiction. Recreational use of ketamine can eventually lead to psychological addiction. This is due to the highly regulated nature of monitored ketamine treatment. There is a very low risk of developing dependence on ketamine from infusions.

Treatment of Alcohol and Heroin Addiction

There were 18.7% (4.1 to 40.4%) more people reporting some benefit and 9.6% (0.2 to 39.4%) more who achieved remission within 24 hours of ketamine treatment. A Cochrane review of randomized controlled trials in adults with major depressive disorder found that when compared with placebo, people treated with either ketamine or esketamine sober house boston experienced reduction or remission of symptoms lasting 1 to 7 days. The Canadian Network for Mood and Anxiety Treatments (CANMAT) recommends esketamine as a third-line treatment for depression. Esketamine was approved as a nasal spray for treatment-resistant depression in the United States and elsewhere in 2019.

A retrospective multicenter cohort study revealed that ketamine is relatively effective and safe for use in treating status epilepticus. Ketamine has been shown to be promising in treating status epilepticus in patients with prolonged seizures . Consequently, there has been considerable interest in the use of antagonists targeting glutamate receptors, particularly ionotropic NMDA and AMPA receptors, in the treatment of epilepsy . This effect is mainly due to ketamine’s inhibitory action on the NMDA receptor that leads to significant increases in glutamate levels in the cortex . In children, ketamine given sublingually exhibited significant improvements in mood and behavior .

If you believe you have a medical emergency, you should immediately call 911. If you have or suspect you may have a health problem, you should consult your health care provider. The information provided through Addictionresource.net should not be used for diagnosing or treating a what is an alcoholic nose drinkers nose health problem or disease.

One of the main challenges with ketamine treatment can be the length of time that the antidepressant effects last after finishing a course of treatment. The doses are lower than those used for anesthesia, usually referred to as sub-anesthetic doses. Due to the bronchodilating properties of ketamine, it can be used for anesthesia in people with asthma, chronic obstructive airway disease, and with severe reactive airway disease, including active bronchospasm.

Environmental influences, particularly peer pressure, also play a significant role in the rising misuse of ketamine, especially among young adults. MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. This is a good example of how an existing drug with a relatively stable and established use in clinical practice can be repurposed for multiple uses. If tachycardia, hallucinations, and hypertension do not improve within 2–3 h with the above treatment, they should be treated accordingly 153,154. Some agitated and aggressive patients require benzodiazepine therapy such as diazepam or lorazepam.

• Vomiting can be expected in 5–15% of the patients; pretreatment with propofol mitigates it as well.
• Perry, 54, began seeking more ketamine than his doctor would give him.
• Ketamine addiction affects you in both the short term and long term, impacting your brain, body, emotions, and social life.
• Over the past two decades, ketamine has emerged as a groundbreaking treatment for refractory depression and suicidal ideation, particularly in patients who do not respond to conventional antidepressants.
• It is important to distinguish between the valid medical uses and the nonmedical uses of the drug.
• Ketamine, generally, stimulates breathing; however, in the first 2–3 minutes of a high-dose rapid intravenous injection, it may cause a transient respiratory depression.

Simmler LD, Li Y, Hadjas LC, Hiver A, van Zessen R, Lüscher C. Dual action of ketamine confines addiction liability. Researchers have used this behavior as an animal model for human depression, and when ketamine is introduced, they stop giving up. It is so unique it may generate other treatments as good or better, such as new molecular variants without psychedelic effects. Ketamine is now a controlled substance in Australia, meaning it has a high potential for abuse. In Australia, 300,000 people said they used ketamine in the previous 12 months, compared to 70,000 in 2016. These unsafe and often contaminated drugs can contain MDMA or ketamine-like analogs that are created and distributed illegally.

Chronic ketamine abuse can damage many organs, including the brain, heart, liver, gastrointestinal tract, and genitourinary system. Although people with certain heart conditions should not take ketamine, it is generally safe when a trained professional administers it in clinical settings. It is important to distinguish between the valid medical uses and the nonmedical uses of the drug. 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 critically important that an individual who engages in inappropriate use of ketamine get professional counseling and treatment.

It starts around 2 to 5 minutes after the dose has been smoked or swallowed. In some cases, it’s used as a date rape drug, as it’s odorless and colorless. The effects of smoking it or swallowing it tend to be less intense than those of directly injecting it.

Also, its intranasal use for patients with major depression and suicidal behavior was approved . Doses which are used for the treatment of depression in adults are 0.5 or 1 mg/kg . Numerous studies examining the impact of ketamine on major depressive disorder indicate a notable and fast alleviation of depressive symptoms following a single ketamine infusion 85,86.

Infusions, in particular, work within hours, which is one of the reasons ketamine Ecstasy ingredients has shown such promise as an intervention for suicidal behavior. Everyone responds a bit differently to ketamine, and nobody is sure exactly why. Some routes of administration, like oral or nasal ketamine, have more frequent dosing schedules, like several times per week over six weeks. Clinics won’t infuse someone for one hundred hours; instead, they give a series of treatments over several weeks. Specifically, low-dose infusions of up to one hundred hours resulted in sustained relief for four to eight weeks. The rest relapsed into depression after about eighteen days on average .