Ketamine

Ketamine is used as a medical anesthetic and as a form of pain management. It can also be prescribed off-label for treatment-resistant mood disorders, such as depression and social anxiety disorder. The FDA approved ketamine as an anesthetic in 1970. In 2019, the FDA approved a form of ketamine called esketamine, a nasal spray for treatment-resistant depression. Esketamine (brand name Spravato) begin at 56 mg doses twice per week. The FDA has not issued guidelines for the off-label use of ketamine for treatment-resistant depression.

Ketamine can be administered as an intravenous (IV) injection, intramuscular (IM) injection, sublingual liquid, oral tablet, or intranasal spray (esketamine) or powder (nonmedical use). Psychedelic doses are about 10–25 percent of anesthetic doses: Intranasal (club “bump”): 200 mg IM injection: 50-150 mg Oral doses: 350-500 mg

Ketamine is a dissociative drug that makes people feel disconnected from their environment and themselves. Dissociative drugs distort a person’s sensations and cause hallucinations, memory loss, and out-of-body experiences. Ketamine is a cyclohexanone derivative. Its chemical name is 2-(2-Chlorophenyl)2(methylamino)cyclohexan-1-one.

Ketamine acts on many different parts of the brain. Specifically, ketamine primarily works by temporarily blocking NMDA receptors in the brain, which increases levels of a neurotransmitter called glutamate. Higher levels of glutamate activate pathways in the brain that contribute to neuroplasticity and healthy cell growth.

The side effects of ketamine include allergic reactions, amnesia, anxiety, changes in mood, changes in heart rate and blood pressure, confusion, double vision, insomnia, involuntary eye movement, muscle stiffness, nausea, seizures, slow breathing, and vomiting.

Emerging clinical research shows that ketamine may help manage anxiety. For example, in a randomized, placebo-controlled trial of 18 adults, ketamine treatments significantly reduced anxiety compared to a placebo.

In the United States, ketamine is only available by prescription. That means it can only be prescribed and administered by a licensed clinician. Unlawful possession of ketamine is punishable by up to one year in jail, a $2,500 fine, or both.

Ketamine can make a person feel relaxed, detached, and calm. It can also cause people to feel confused or agitated. Ketamine reduces sensations in the body, making you feel like you’re having an out-of-body experience.

There are no controlled data about ketamine use during human pregnancy. Therefore, ketamine is not recommended for pregnant women.

Ketamine is dangerous when mixed with alcohol. Both of these drugs alter neurotransmitters (chemical messengers) in the brain. Using ketamine with alcohol increases the risk of heart problems, memory loss, slowed breathing, and even death.