What is Ketamine?
About Ketamine
Ketamine is on the World Health Organization’s list of essential medications and is approved by the US Food and Drug Administration for use as an anesthetic. Esketamine, which is one of racemic Ketamine’s two enantiomers, is approved by the FDA for Major Depressive Disorder and Suicidal Ideation and Gestures. It’s been used regularly in emergency departments and operating rooms for anesthesia and pain relief since the 1970s and is used on a daily basis approximately 30,000 times per day in Operating Rooms and Emergency Departments across the United States.
It’s a selective antagonist of the N-methyl-D-aspartate (NMDA) receptor, and activates two other receptors, AMPA and Tyrosine Kinase B. It’s regularly referred to as ketamine treatment or ketamine therapeutics.
Over the past twenty two years, studies have shown ketamine to be an effective treatment option for patients clinical depression, chronic depression, depression symptoms, major depressive disorder and treatment resistant depression. In addition, it has shown tangible results with treatment of suicidal ideations or thoughts. Lastly, ketamine has is able to help relieve anxiety, PTSD, Chronic Pain Syndromes and head aches or migraines .
How Ketamine Works
Ketamine works differently than traditional antidepressants such as SSRI and SSNI medications. The mechanism by which ketamine produces it’s antidepressant effects are hypothesized to include the blocking of the NMDA Receptor, interacting with the AMPA Receptor, activating mTor molecule in the cell, which in turns releases G proteins that instruct the nerve cell to grow additional dendritic spines and increase the amount of glutamate produced. Ketamine also reduces the production of nitric oxide and interacts with the opioid receptors which decreases the sensations of pain.
- Bronchodilation, which increases airflow to the lungs
- Occasionally nausea and rarely vomiting – these appear to be dosage-dependent
- Cardiovascular changes that may include an increased heart rate and blood pressure
Routes of Ketamine Administration
Ketamine may be administered in the form of a pill, nasal spray, intramuscular injection, or intravenous infusion. When used in the hospital for anesthetic or pain control purposes, ketamine is usually administered intravenously. Ketamine infusions and nasal sprays are also used to treat other conditions in an outpatient setting, often as an off-label (Non FDA Sanctioned) use.
Overdose Effects of Ketamine
Ketamine overdose can lead to several severe and life-threatening effects. One major impact is an altered level of consciousness, which can range from mild drowsiness to a complete inability to wake up. Additionally, an overdose can result in dangerously slow or irregular breathing, increasing the risk of respiratory failure.
Other potential effects include:
- Sensory-Perceptual Alteration: Disturbances in your senses including visual, auditory, touch, smell, and taste can be intense and disorienting, occasionally causing significant distress.
- Elevated Blood Pressure: In some cases, blood pressure can spike to very high levels.
- Impaired Motor Function: Severe incoordination and muscle rigidity may occur.
- Cardiovascular Issues: Possible irregular heartbeats or even cardiac arrest.
- Laryngospasm: A sudden, involuntary contraction of the vocal cords that can make it difficult to breathe or speak
Recognizing these symptoms promptly and seeking immediate medical attention can be crucial in mitigating the risks associated with a ketamine overdose, which is one reason that it’s imperative to have a trained and experienced physician and Registered Nurses present when you are under the influence of anesthetics.
If someone exhibits signs of an overdose, call emergency medical services right away. Early intervention can make a significant difference in outcomes.
Ketamine Side Effects
Ketamine is a very safe medication, but side effects may occur. To ensure your safety, a physician and registered nurse will be present and will monitor you during the entire course of the infusion. If you experience any side effects during or after your infusion, report them to your doctor or nurse right away.etamine overdose can lead to several severe and life-threatening effects.
- Spasm of the vocal cords (laryngospasm)
- Airway obstruction
- Respiratory arrest
- Blood pressure changes
- Rapid heart rate
- Slow heart rate
- Abnormal heart rhythm
- Increased intracranial pressure
- Rash
- Nausea and vomiting
- Increased salivation
- Low appetite
- Visual changes
- Pain at the injection site
Discovery and History of Ketamine
Ketamine was first discovered in 1962 when it was synthesized in a laboratory. After two years of successful tests on animals, researchers began testing the drug on human subjects in 1964. The FDA first approved ketamine for use as an anesthetic in 1970, and doctors began using this drug on soldiers injured during the Vietnam War.
Because of its sensory-preceptive altering and dissociative properties, ketamine became a recreational drug as well. Following FDA approval, recreational use increased, and it was classified as a controlled substance in the US in the 1990s.
Uses of Ketamine
In sub-anesthetic doses, ketamine can successfully treat mood disorders, including depression, PTSD and OCD, as well as anxiety. For the greatest chance of prolonged remission from symptoms, a series of infusions are scheduled over a two-to-three-week period. In 2019, a form of ketamine was approved to treat depression
Multiple studies have shown promising results when ketamine is used to treat different conditions involving pain or mood disturbances. According to the World Health Organization, potential new therapeutic uses include treatment for depression and refractory status epilepticus. The use of ketamine for treating depression is under evaluation in Phase III clinical studies. As noted in the report, levels of ketamine abuse appeared to be declining in many countries worldwide. As a result, the FDA approval for the treatment of these conditions may face less resistance in the future.
Studies on Ketamine
Ketamine is being studied for several other possible uses.
Ketamine for Depression
According to a review published in World Psychiatry, several randomized trials have supported the use of ketamine for the treatment of depression, including bipolar depression. Additional studies mentioned in this review showed that ketamine can rapidly reduce suicidal thinking. Furthermore, the data from these studies indicates that ketamine is relatively safe and well-tolerated by most patients, making it an ideal treatment option
Good read on blog:“Ketamine offers lifeline for people with severe depression”
Considerations for Patients with Chronic Pain and Mood Disorders
The Food and Drug Administration has approved ketamine for both anesthesia and pain control. In March 2019, a form of ketamine was even approved for the treatment of treatment-resistant depression. However, the FDA has not yet approved ketamine for the treatment of other mood disorders or chronic pain alleviation. Ketamine infusions for these indications are considered an “off label” usage of the medication. Because of this, insurance companies and government insurance programs like Medicaid and Medicare do not reimburse physicians for these infusions. However, if you need treatment with ketamine for one of these off-label purposes, you can pay for the treatment yourself.
What are the Street Names for Ketamine?
Ketamine, a well-known anesthetic with hallucinogenic properties, is often referred to by various street names. Some common ones include:
- Cat Tranquilizer
- Jet K
- Kit Kat
- Purple
- Special K
- Super Acid
- Super K
- Vitamin K
These names are often used in different regions or communities, reflecting the drug’s unique effects and its diverse range of users.
How is Ketamine Abused?
- Injected: Users often inject ketamine directly into their bloodstream for rapid effects.
- Liquid Form: It can be mixed with liquids and consumed orally.
- Powder Form: The powdered version is frequently snorted or mixed into drinks.
- Smoked: Some users smoke ketamine by incorporating it into tobacco or cannabis products.
These varied methods of administration highlight the drug’s versatility and its appeal among recreational users.