What is ketamine?
Ketamine is a potent anesthetic and dissociative substance. Ketamine does not belong to the category of classic psychedelics, but has some psychedelic effects. Ketamine is a controlled substance, but in 2019 it received FDA approval as a break-through therapy for depression.
Ketamine is typically consumed as a powder, liquid, or nasal spray.
What is the ketamine experience like?
In low doses, ketamine may cause tingling in extremities, numbness, rapid breathing, jerky movements, and dizziness. Effects also include a sense of weightlessness, euphoria, mild visual effects, introspection, and blurred vision. A participant’s appreciation for sound and music may be enhanced.
Higher doses of ketamine are likely to cause distortions to vision, hearing, and even taste. Hallucinations are common. At very high doses, participants reports experiences of the famous “K-hole,” in which a person’s awareness of one’s body and environment dissolve completely. At this dosage, it is common to experience ego-death, time distortions, and out-of-body experiences.
A brief history of ketamine
Ketamine was discovered in 1956. It was approved for medical use as an anesthetic in the United States in 1970, and was used during the Vietnam War. The substance became popular as a recreational drug during the 1980s and 1990s, especially in rave culture. Since receiving FDA approval for the treatment of depression, thousands of legal ketamine treatment centers have opened around the world.
Evidence indicates that ketamine is safe when used occasionally in a therapeutic setting. When the substance is used frequently, studies show that negative effects on cognition can occur, particularly regarding memory and clarity of thought. Frequent, repeated use of ketamine can also evoke schizotypal symptoms in vulnerable users.
There is also some indication that ketamine use over a prolonged period of time is linked to chronic bladder pain and urinary tract problems, although the relationship is not yet well understood.
Ketamine can cause some moderate spikes in blood pressure and intercranial pressure. Individuals with thyroid disease, coronary artery disease, alcoholism, high blood pressure, and a history of aneurysms should exercise caution when using ketamine.
Ketamine interacts negatively with several other types of drugs and medications, including stimulants (cocaine), opioids (heroin, fentanyl), antihistamines, barbiturates (e.g. Butisol, Amytal, Nembutal); zolpidem (Ambien), and benzodiazepines (e.g. Xanax, Ativan, Klonopin). These substances should never be combined with ketamine.
Unlike classic psychedelics, ketamine is a derivative of PCP and is soluble in water. Whereas classic psychedelics are serotonergic, ketamine is an antagonist of the NDMA receptor in the brain. The interaction between the substance and the NMDA receptor produces the substance’s analgesic, anesthetic, and psychotomimetic effects.
Structurally, ketamine is an equal mixture of two enantiomers: esketamine and arketamine. The drug’s hallucinogenic effects arise from esketamine, which is the more potent NMDA receptor antagonist.
Ketamine is a fast-acting, effective treatment for depression. One study indicated that a significant change in depressive mood and suicidal ideations in subjects occurred within hours of consuming the substance. Researchers have hypothesized that the drug’s effect in treating depression is due to the NMDA receptor antagonism. There is also speculation that, like classic psychedelics, ketamine is able to repair damaged synapses and promote neurogenesis.