Author: Alex Thompson

Ketamine National Institute on Drug Abuse NIDA

But there is still much to learn about how ketamine works, which dosages are effective, and how safe it is. By Sara Hoffman, PharmDHoffman is a Kansas-based clinical pharmacist with experience working in hospitals, specialty clinics, and community pharmacies. These groups recognize that more thorough and consistent research is needed. The drug is also not suitable for individuals with schizophrenia or who are pregnant or breastfeeding.

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Thus, higher doses produce more pronounced delirium and other symptoms of hallucination than do lower doses. Ketamine, general anesthetic agent related structurally to the hallucinogen phencyclidine (PCP). Ketamine was originally patented in Belgium in 1963 and was approved for use in humans by the U.S. Soon after, it was put to use to treat American soldiers fighting in the Vietnam War.

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As is often the case, enthusiasm and marketing have gotten ahead of the evidence. Ketamine is a non-barbiturate general anesthetic and an NMDA receptor antagonist. It is available as an injectable drug, ketamine hydrochloride, approved for anesthesia in diagnostic and surgical procedures–both alone or in combination with other anesthetic drugs. Esketamine (Spravato) is used to treat depression; it is one of the forms of racemic ketamine and was FDA-approved in 2019 for specific types of depression. Spravato is a nasal spray that is used under strict medical supervision and is not used by patients at home.

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Opioids treat pain by binding to mu-opioid receptors in your brain and spinal cord and producing a response that controls the amount of pain you feel. Aside from the above drug interactions, a 2017 study reports that taking ketamine with amphetamine-like stimulants can produce undesirable effects. Individuals who take ketamine recreationally report sensations, such as being separated from their body or a pleasant feeling of floating. Some people have an almost complete sensory detachment that they compare to a near-death experience. Research in 2017 notes that some studies indicate ketamine can quickly relieve depression in people who do not respond well to other treatment. Keep reading to learn more about the uses, side effects, and risks of ketamine, as well as its interactions with alcohol and other drugs.

Today, since ketamine can produce minor hallucinogenic side effects in humans, it is used most often as a veterinary anesthetic. However, the drug does have valuable applications in human medicine, especially as an anesthetic for children and for individuals undergoing minor surgery. Like opioids, ketamine does cause sedation (a relaxed and sleepy state). It can also produce dissociative feelings, hallucinations, and amnesia (no memory of events while under the influence of the drug). It is also similar to opioids in that it has a high abuse potential.

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Organizations containing experts on pain management and anesthesia have responded to requests for guidelines on using ketamine to manage pain, since it is still an off-label use. This use must be guided by the experience and opinion of field experts rather than by the prescribing information that comes with FDA approvals of new indications. While ketamine shares some characteristics with opioids, such as producing sleepiness and having a potential for abuse, it is a different type of drug from opioids. In contrast, no recreational use of the drug is safe, as it can cause addiction and adverse health effects that can lead to death.

1. Because of this analgesic effect, ketamine has started to be widely used for treating pain despite not having FDA approval for any pain indication.
2. The drug is also not suitable for individuals with schizophrenia or who are pregnant or breastfeeding.
3. The biggest concern is that the effects aren’t always short-lived and the onset of these effects isn’t always immediate.
4. Ketamine is a non-barbiturate general anesthetic and an NMDA receptor antagonist.

In clinical trials ketamine infusion therapy dose is lower than an anesthetic dose. If patients have not responded to several initial infusions, then it appears unlikely that they will respond to further infusions. Thanks to an interesting loophole in the laws governing drug advertising, ketamine is now marketed for the management of any number of different psychiatric illnesses. Depression, anxiety, post-traumatic stress disorder, and chronic pain are the big ones, but it’s also being marketed for other uses, ranging from Lyme disease to alcoholism to opioid addiction.

In the past few years, ketamine has generated much research on its benefits in treating certain mental health conditions. But there is still much more to learn about how ketamine works, how it could be dosed, and what long-term effects it may have on the body. Pharmacies in almost every state also use PDMP, or prescription drug monitoring programs. These programs prevent people from filling controlled substances at different pharmacies repeatedly in a short period. Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, and it blocks HCN1 receptors.

Using ketamine without a prescription is illegal, and street ketamine may be mixed with other substances that can increase your risk of a serious reaction. The DEA says higher doses of recreational ketamine can cause serious reactions. It is classified as a Schedule III non-narcotic substance in the United States and is illegal without a prescription. However, it is a Schedule III controlled substance, while most opioids are Schedule II because they carry a higher risk of abuse and dependence.

While ketamine is safe to use in controlled medical practice, it becomes hazardous if someone takes it for recreational use as it may result in potentially life-threatening adverse effects. The drug is a Schedule III non-narcotic that the Food and Drug Administration (FDA) has approved for use only as a general anesthetic. However, doctors sometimes prescribe it for “off-label” uses, such as depression. Off-label means using the drugs to treat conditions the FDA has not approved. When abused, it is typically insufflated (“snorted” up the nose) in social situations. It is also injected, consumed orally as a liquid (mixed into drinks), or smoked in marijuana or tobacco.