Ketamine

aka Ketalar

Ketamine is an arylcyclohexylamine commonly used as a rapid-acting general anesthetic used in human and veterinary medicine. In 1970, the Food and Drug Administration (FDA) approved Ketamine as an anesthetic drug and now the drug is legally being prescribed off label for a number of indications. Outside of surgery, Ketamine is used as an analgesic, anti-obsessional and antidepressant compound that has neuroprotective (protects nerve cells from damage, degeneration, or impairment) and neuroplastic (brain growth) properties. When used in a medical or clinical setting, Ketamine is considered to be relatively safe and has fewer side effects to the circulatory and respiratory systems compared to most other anesthetics.

When Ketamine is administered in low to moderate doses with the intention of altering consciousness, a therapist will sit and talk to the patient while they experience the effects of Ketamine. When Ketamine is administered in higher doses, a person may have mystical-type experiences or ego dissolution which can be incredibly negative if a person is not adequately prepared and supported during an after the experience.

Thinking about embarking on a Ketamine Journey for a mental health condition? Here’s what we think you should know beforehand.

Ketamine is being offered across the country in many medical clinics that are typically ran by Anesthesiologists or Certified Registered Nurse Anesthetists (CRNAs). These clinics can be busy and real money makers for providers since this type of therapy is incredibly expensive to receive while the medication itself is quite affordable for providers to carry. Please do your homework and locate a clinic and provider that you feel comfortable embarking on this journey with.

You should ALWAYS be offered a PREPARATION session where you go to the clinic, meet the provider(s) and are offered a full explanation of how the therapy is administered and what to expect on the day you return to receive the medicine. Come prepared with a your questions. If something doesn’t feel quite right, please explore that. This journey is for you and the set and setting is vital for the safety of your experience. Once you’ve completed your preparation session, you’ll be able to set up your first Ketamine Treatment. Here’s a few things that are not generally offered at Ketamine clinics, but the research shows are paramount for the experience.

  • Bring an eye Mask! This is an inner journey. There’s nothing to see in the external world. It all comes from within.

  • Bring Headphones and a source to listen to music.

    • Download a playlist to the device prior to your appointment. If you are using a cell phone to listen to your music, make sure to turn the phone on Do Not Disturb because a phone call or text message could really detour your journey.

    • Infusions last about 45 minutes so make sure whatever playlist you choose is longer than that.

  • Do NOT attempt to drive after this experience. Plan ahead. Get a ride home!

  • In all psychedelic journeys, what may be most important is integrating what came up for you after the therapy. Please set this up before your first administration session. If you don’t have a therapist to integrate with, please visit our integration page to locate a coach or therapist that can support you.

    • The science is undeniable. Integrating your experience with a professional offers a person the best possible benefits. Please don’t skip this very important step.

Clinical Indications

Approved Indications:

  • Anesthetic compound for diagnostic and surgical procedures

Common Off-Label Indications

  • Pain

  • Major Depressive Disorder

  • Mood Disorders

  • Addiction Disorders

  • Posttraumatic Stress Disorder

Characteristics

  • Ketamine is a non-competitive NMDA antagonist that blocks excitatory signaling of glutamate and interacts with a number of receptor targets including: opioid, monoaminergic, cannabinoid, nitric oxide, muscarinic, nicotinic, and sigma receptors

  • Depending on the route of administration, one may experience slight perceptual perceptions to paralysis with complete dissociation to sedation.

  • Long term use and high doses of Ketamine are more commonly associated with potential adverse effects along with an increased risk of dependence.

Effects

Positive Effects

  • Drowsiness

  • Dissociation between the mind and body

  • Initiates experiences that are out-of-body

  • Changes in perception, cognition, and emotion

  • Vivid Imagery and visual hallucinations

  • Mood Enhancement

  • Ego Dissolution

  • Transcendence of space and time

  • Mystical Experiences

  • Experiences of death and rebirth

  • Muscle Relaxation

  • Relief of Pain

Acute Negative Effects

  • Anxiety

  • Drowsiness

  • Paranoid Delusions

  • Dysphoria

  • Distorted perceptions of body and self

  • Loss of coordination

  • Disorientation

  • Confusion

  • Muscle Trembles or Muscle Jerks

  • Psychotic Episodes

  • Accidents: commonly from falls, using a car or going in water

  • Psychological Distress

  • Loss of airway function (rare)

Negative Effects from Prolonged Use

  • Toxicity of the Bladder and Kidneys

  • Urinary dysfunction

  • Physical and Psychological Dependence

  • Misuse, tolerance and addiction

  • Withdrawal syndrome

  • Flashbacks

Legal Status

Ketamine is a synthetic dissociative anesthetic approved for legal use with a prescription for a clinical indication in the United States as a Controlled III Substance.

Dosing

Intravenous (IV) -

  • 0.5 mg/kg over a 40 min infusion

  • Dose for anesthesia induction: 1.0-4.5mg/kg

    • When administered IV, effects being in about 40 seconds

Intramuscular (IM)-

  • Low Dose: 0.25 - 0.5mg/kg

  • Moderate Dose: 0.5-1.0mg/kg

  • High Dose: 1.0-2.0 mg/kg

  • Dose for anesthesia induction: 6.5-13.0mg/kg

    • When administered IM, effects begin in 3 minutes and last for 75 minutes. Sessions can last 2-4 hours.

Nasal

  • 25-300mg

Lozenge (transbuccal/sublingual

  • 50-300mg