Author: Gary Jackson

Ketamine Toxicity StatPearls NCBI Bookshelf

Despite these positive results, the authors warn that data on the use of ketamine for this condition are limited, so practitioners should consider the risks of the drug before prescribing it. 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.

Aside from its medical use as an anesthetic, ketamine is prescribed by some healthcare providers as an alternative treatment for severe depression. The Food and Drug Administration (FDA) has not approved ketamine as a treatment for any psychiatric disorder. The only FDA-approved option is Spravato, a nasal spray made from a derivative of ketamine, which is used for treatment-resistant depression in adults. Once someone has been medically stabilized from a ketamine overdose, this may be an ideal time to speak to them about the benefits of seeking substance misuse treatment regarding their ketamine use (or use of other drugs). Addressing the behavioral aspect of ketamine misuse through professional intervention could be a valuable tool in preventing these dangers from being realized. In conclusion, ketamine toxicity and addiction pose significant risks to a small segment of the population, and given increasing utilization, the prevalence of these phenomena is expected to increase.

Spiritual and Mystical Experiences

This feels like your mind and body have separated and you can’t to do anything about it – which can be a very scary experience. Users often talk of taking a ‘bump’, meaning they snort a small amount of ketamine. 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. Some people are selling a form of street ketamine mixed with cocaine called “Calvin Klein,” a combination Giordano specifically cautioned against. “There have been a couple of case reports when people have shown up in an emergency room when they’re highly dissociated and on a coke high, so they completely act out or they become very agitated,” he said. In another new model of ketamine therapy that’s gained popularity in the age of social distancing, some clinics will prescribe ketamine tablets for patients to take at home while they video chat with a clinician.

Ketamine treatments result in neurogenesis and neuroplasticity in our brains for about 72 hours. We know that in rodent studies, ketamine can cause the brain to grow new nerve cells and can make existing nerve cells sprout new connections between each other. It is thought that the creation of new cells and strengthening of nerve pathways may be correlated with new learning. This is one reason professionals are interested in adding talk therapy or new learning to the ketamine treatment process, as the ability to think in new ways and engage in new behaviors may be amplified during and after ketamine treatment.

History and Physical

Because several other trials indicate ketamine may have significant antianxiety effects, the authors encouraged future studies to explore this possible benefit more fully. A 2016 study cautions that the inappropriate use of ketamine is a worldwide health problem due to its hallucinogenic properties. With this in mind, they urge doctors to prescribe standard antidepressants before trying ketamine for depression.

This medication is considered safe and may reduce the need for post-operative pain medication. 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. Ketamine is an injectable anesthesia that has been used in humans and animals since 1970. It is referred to as a “dissociative anesthetic hallucinogen” because it makes people feel detached from their pain and surroundings. However, it’s still illegal to possess or sell ketamine outside of medical settings.

Treating depression

Most studies of ketamine’s effects on the brain to-date have looked at the effects of acute exposure—how one dose affects the brain in the immediate term. For this study, researchers examined repeated daily exposure over the course of up to ten days. Statistically significant alterations to the brain’s dopamine makeup were only measurably detectable after ten days of daily ketamine use. The researchers assessed the effects of repeated exposure to the drug at two doses, one dose analogous to the dose used to model depression treatment in mice, and another closer to the dose that induces anesthesia.

Ketamine, an FDA approved anesthetic agent, is being used off-label to treat a variety of mental health issues. While there is the most research for treatment refractory depression (including bipolar depression), suicidal ideation, PTSD, and addiction, there is also research suggesting beneficial effects for OCD, anxiety, eating disorders, and end-of-life care. There’s some suggestion that ketamine could be effective for treatment-resistant depression, a notoriously difficult condition to treat (hence the name). A pilot study conducted in Oxford gave 28 patients with severe treatment resistant depression or bipolar disorder low doses of intravenous ketamine over three weeks.