What is Ketamine?

Ketamine is a dissociative anesthetic that has been used for decades in both human and veterinary medicine. It was originally developed for surgical anesthesia, where it helps patients undergo procedures with minimal pain and without complete loss of consciousness.

In recent years, however, ketamine has emerged as a breakthrough treatment for severe, treatment-resistant depression and certain chronic pain conditions. When you receive ketamine, it doesn’t simply put you to sleep; it alters your perception of reality by disrupting normal brain signaling, which can lead to vivid hallucinations and a sense of detachment from your body and surroundings which is also called as k-hole.

Clinically, ketamine is administered under strict supervision to ensure safety, and its dosing is carefully calibrated to produce the desired therapeutic effects. This means that while ketamine can be extremely effective, it must be used responsibly to avoid its potential risks. For those curious about its broader applications, ketamine’s use in psychiatry has opened new avenues for treating mood disorders that have not responded to traditional antidepressants.

Ketamine Overdose

Although ketamine is safe when used correctly under medical supervision, an overdose can lead to serious and potentially life-threatening complications. Overdosing on ketamine may result in profound sedation, dangerously slowed breathing, extreme confusion, and a significant drop in blood pressure. When these symptoms occur, rapid medical intervention is essential to stabilize the patient and prevent long-term damage.

It is important to note that the risk of overdose is heightened when ketamine is combined with other central nervous system depressants such as alcohol or benzodiazepines. The U.S. Food and Drug Administration (FDA) has issued warnings about the misuse of ketamine outside of clinical settings, and healthcare providers closely monitor dosing to minimize the risk of accidental overdose.

What Does Ketamine Do to Your Brain and Body?

Ketamine exerts its effects primarily by blocking NMDA receptors, which play a critical role in the transmission of pain signals, memory, and mood regulation. This receptor blockade disrupts the normal processing of sensory information, leading to a dissociative state where you may feel detached from your body and your environment. In addition to its anesthetic properties, ketamine triggers a cascade of neurochemical events that promote synaptogenesis— the formation of new neural connections—which is believed to underlie its rapid antidepressant effects.

On the body, ketamine produces profound analgesia, reduces inflammation, and can even modulate the immune system. However, its powerful effects can also lead to side effects such as increased heart rate, elevated blood pressure, and, in some cases, hallucinations or vivid dreams. These complex actions make ketamine a versatile drug in medical treatment, but they also underscore the need for precise dosing and careful monitoring.

“The mechanism of ketamine not only provides rapid pain relief and mood improvement but also supports the growth of new neural pathways, which is promising for long-term recovery,” explains Dr. Robert H. Dworkin, a pain management specialist3.

However, these same effects can also lead to side effects such as dizziness, nausea, and temporary cognitive impairment.

If abused regularly, ketamine can lead to a serious condition known as ketamine-induced cystitis (commonly referred to as ketamine bladder). This condition arises from the toxic effects of ketamine and its metabolites on the bladder wall, resulting in chronic inflammation, damage to the epithelial lining, and, in severe cases, irreversible scarring.

Ketamine and Alcohol

Combining ketamine and alcohol can lead to dangerous interactions that amplify the depressant effects of both substances. When used together, these drugs can significantly impair your central nervous system, resulting in severe physical and cognitive side effects. Below is a detailed list of the effects and side effects associated with mixing ketamine and alcohol:

  • Enhanced Sedation: Both ketamine and alcohol cause drowsiness; when combined, they can lead to extreme sedation that impairs alertness and the ability to perform daily tasks safely.
  • Respiratory Depression: The synergistic depressant effects can slow breathing to dangerous levels, increasing the risk of respiratory failure and potentially fatal outcomes.
  • Impaired Motor Function: Users may experience significantly reduced coordination and slower reaction times, which heightens the risk of accidents and injuries.
  • Cognitive Impairment: Mixing these substances can cause confusion, memory lapses, and difficulty concentrating, affecting your judgment and overall cognitive performance.
  • Increased Risk of Overdose: The combination can lead to unpredictable effects, making it easier to accidentally consume a toxic dose, even if each substance is taken in moderate amounts separately.
  • Blackouts and Loss of Consciousness: The compounded effects may cause periods of amnesia or complete loss of consciousness, posing serious safety risks.
  • Gastrointestinal Distress: Nausea and vomiting can be exacerbated by the interaction, leading to dehydration and further complications.
  • Emotional Dysregulation: The mixture can heighten anxiety, agitation, or depressive symptoms, further impacting your mental well-being.

Given these serious risks, do not use ketamine with alcohol.

If you or someone you care about is using these substances together, seek immediate professional help to revert the potential for life-threatening complications.

Is Ketamine a Psychedelic?

Ketamine is not a classic psychedelic like LSD or psilocybin, but it does produce hallucinogenic and dissociative effects that many users describe as psychedelic. At higher doses, ketamine can induce intense visual and auditory hallucinations, distort the perception of time and space, and create feelings of euphoria or, conversely, deep anxiety. These effects are why some experts refer to ketamine as a dissociative psychedelic.

Its unique ability to alter consciousness is both a therapeutic asset and a potential risk factor, especially when used recreationally. In controlled clinical settings, these psychedelic effects are harnessed to help patients gain new perspectives on their mental health challenges, though they are carefully managed to avoid negative outcomes.

Ketamine Hangover

Many users experience what is commonly referred to as a “ketamine hangover” after the drug’s primary effects have subsided. This hangover can include lingering drowsiness, cognitive fog, and a general sense of disorientation or fatigue that lasts for several hours, and in some cases, into the next day. Such after-effects may impact your ability to perform daily activities, especially if you have important tasks or decisions to make.

The duration and intensity of a ketamine hangover can vary based on the dose administered, the method of intake, and your individual metabolic rate. Clinicians typically advise patients to plan for rest and avoid tasks that require full cognitive function until the hangover symptoms fully dissipate.

Ketamine Infusion

Ketamine infusion therapy is an innovative treatment method that involves the slow, controlled intravenous administration of ketamine over a period of time. This approach is used increasingly in the treatment of severe, treatment-resistant depression and chronic pain conditions. During a ketamine infusion, medical professionals carefully monitor your vital signs and adjust the dosage to maximize therapeutic benefits while minimizing potential side effects.

Many patients report rapid improvements in mood and pain relief, sometimes within hours of the infusion. However, the treatment requires a series of sessions and ongoing evaluations to determine its long-term effectiveness and safety, making it a critical component of a broader, individualized treatment plan.

Dr. Michael E. Nici, an expert in chronic pain management, states, “Ketamine infusion therapy has opened new doors in the treatment of chronic pain and depression, offering hope to patients with few other options”5.

Numbing Spray

In addition to systemic administration, ketamine is available as a numbing spray designed to provide localized pain relief. This formulation is used in certain medical procedures to numb a specific area, reducing pain without causing the widespread dissociative effects associated with intravenous use. The numbing spray works by delivering ketamine directly to the site of discomfort, which can be particularly useful in dental procedures or minor surgical interventions.

While the numbing spray offers the advantage of targeted analgesia, its use is typically limited to controlled clinical environments where its effects can be closely monitored. People tend to dilude the ketamine and do their own nasal sprays to abuse ketamine outdoors, such as music festivals.

Is Ketamine a Horse Tranquilizer?

Although ketamine is also nicknamed as a horse tranquilizer due to its use in veterinary medicine, this label is misleading when applied to its use in human medicine. In veterinary settings, ketamine is administered to large animals like horses for anesthesia, but the dosages and formulations for humans are carefully tailored to ensure safety and efficacy. In human medical practice, ketamine is dosed precisely for its role as an anesthetic and, more recently, as a treatment for depression and chronic pain. The term horse tranquilizer oversimplifies the complex pharmacological profile of ketamine.

Medical authorities such as the FDA and research from the NIH make it clear that while ketamine has versatile applications across species, its use in humans is strictly regulated and vastly different from its use in animals.

Conclusion

Ketamine is a multifaceted medication with powerful therapeutic benefits when used appropriately, ranging from anesthesia and pain management to groundbreaking treatments for depression. Its capacity to alter perception and promote neuroplasticity makes it a valuable tool in clinical settings.

However, these same properties also contribute to significant risks when ketamine is misused, such as overdose, dangerous interactions with other substances, and severe after-effects like a ketamine hangover. Whether administered as an infusion, a numbing spray, or in traditional injectable forms, ketamine demands precise dosing and close monitoring to maximize benefits and minimize harm.

If you or a loved one is facing challenges related to ketamine misuse or are considering ketamine as a part of a treatment plan, it is crucial to seek professional guidance.

References

  1. National Institutes of Health. Ketamine in Clinical Practice: Emerging Applications and Research. Available at: https://www.nih.gov.
  2. U.S. Food and Drug Administration. FDA Information on Ketamine. Available at: https://www.fda.gov.
  3. American Journal of Psychiatry. Ketamine’s Mechanism of Action and its Role in Treating Depression. Available at: https://ajp.psychiatryonline.org.
  4. Substance Abuse and Mental Health Services Administration. Ketamine: Risks, Benefits, and Clinical Guidelines. Available at: https://www.samhsa.gov.
  5. Journal of Clinical Sleep Medicine. Exploring the Psychotropic Effects of Ketamine. Available at: https://jcsm.aasm.org.
  6. Mayo Clinic. Ketamine Infusion Therapy: Benefits and Considerations. Available at: https://www.mayoclinic.org.
  7. Veterinary Information Network. Ketamine in Veterinary Medicine. Available at: https://www.vin.com.