Ketamine is a medicine that is used to create a state of unconsciousness, often known as anesthesia, in the patient. It has the ability to induce relaxation and pain relief in both humans and animals.
It is a scheduled medicine in the third class, and it is approved for use as an anesthetic in hospitals and other healthcare facilities.
However, because of its hallucinogenic, tranquilizing, and dissociative effects, it is also a commonly misused “recreational” drug, as seen by the prevalence of its abuse.
Conflict has arisen about using ketamine “off-label” to treat depression. A drug’s off-label use is any use that has not been approved by the Food and Drug Administration of the United States (FDA).
Ketamine is a medication that is safe to use in supervised medical settings, but it has the potential to be abused. When used outside of the allowed limits, its adverse mental and physical health consequences can be extremely dangerous to one’s health. Tolerance and psychological addiction might develop as a result of prolonged use.
What is ketamine?
Ketamine is a dissociative anesthetic, which means that it belongs to a class of medications known as dissociative anesthetics. It is also known as Ketalar, Ketanest, and Ketaset.
In addition to the hallucinogen phencyclidine (PCP), dextromethorphan (DXM), and nitrous oxide, also known as laughing gas, there are several other medications in this group.
These sorts of medicines can cause a person to feel detached from their senses and their environment, as if they are floating outside of their physical body.
Therapeutic uses
Ketamine is most commonly utilized in veterinary treatment, where it is extremely effective. In humans, it has the ability to induce and maintain general anesthesia before to, during, and after surgery, among other things.
Ketamine is administered through an intravenous (IV) line for medicinal purposes. It can be injected into a muscle or delivered intravenously.
The fact that it does not lower blood pressure or slow breathing rate makes it a safe anesthetic, according to medical experts.
Because it does not require a power source, oxygen, or highly trained personnel, it is a viable choice in less developed countries and disaster-stricken areas.
In human medical practice, it is used in processes such as:
- cardiac catheterization
- skin grafts
- orthopedic procedures
- diagnostic procedures on the eye, ear, nose, and throat
- minor surgical interventions, such as dental extractions
This medication has been used in a hospital environment to control seizures in individuals suffering from status epilepticus (SE), a kind of epilepsy that can result in brain damage and death if not treated promptly. Researchers, on the other hand, point out that ketamine is typically utilized for this reason only after 5 to 6 other approaches have been tried and failed.
It also has analgesic properties, and when taken in small dosages, it can help to reduce pain.
The use of ketamine infusions dramatically improved the symptoms of post-traumatic stress disorder (PTSD) in 41 individuals who had experienced a variety of traumas, according to research published in 2014.
Researchers are looking at various potential medical applications for ketamine, particularly in the treatment of treatment-resistant depression, suicide prevention, and substance use disorders, among other areas. This application, on the other hand, is disputed.
Treating depression
A handful of doctors are using ketamine “off-label,” according to APA researchers who published their findings in April 2017. Ketamine is used to treat persons who are experiencing treatment-resistant depression.
They do, however, issue a warning:
The limits of the existing data as well as the potential risks connected with the medicine should be considered when considering ketamine as a therapy option for people with mood disorders.
The Food and Drug Administration has not yet approved it for use in treating depression.
In an article published in BMC Medical Ethics, researchers encourage doctorsto “minimize the danger to patients” by reviewing carefully the evidence before administering ketamine off-label for patients to treat depression and prevent suicide.
According to the authors, ketamine prescriptions are a “questionable practice” due to a lack of sufficient scientific data to verify that the drug’s use is safe, and certain studies supporting its use have not been sufficiently rigorous in terms of research ethics.
They advocate for a more open dialogue, more study, and for clinicians to consider all other possibilities before prescribing ketamine as a treatment option for depression.
The National Institutes of Health (NIH) is now supporting research to determine whether ketamine can be used to treat persons who are suffering from treatment-resistant depression.
Effects
Ketamine use can have a wide variety of adverse effects, including:
- drowsiness
- changes in perceptions of color or sound
- hallucinations, confusion, and delirium
- dissociation from body or identity
- agitation
- difficulty thinking or learning
- nausea
- dilated pupils and changes in eyesight
- inability to control eye movements
- involuntary muscle movements and muscle stiffness
- slurred speech
- numbness
- amnesia
- slow heart beat
- behavioral changes
- increased pressure in the eyes and brain
It can also result in a loss of appetite, an upset stomach, and vomiting in some individuals.
To prevent hallucinations when used as an anesthetic in humans, doctors mix it with another medication.
Risks
Due to the fact that it does not impact the protective airway reflexes and does not depress the circulatory system in the same manner that other anesthetic medicines do, ketamine is believed to be generally safe in medical settings.
Some people, however, have reported experiencing disconcerting sensations after waking up from ketamine anesthesia.
Ketamine can produce a rise in blood pressure as well as an increase in intracranial pressure, which is the pressure inside the brain.
Ketamine cannot be administered for medicinal purposes to anyone who have the following conditions:
It is used with caution in those with:
- coronary artery disease
- increased blood pressure
- thyroid disease
- chronic alcohol addiction
- acute alcohol intoxication
- aneurysm
- chest pain
- mental illness
People over the age of 65 may be more susceptible to these side effects.
Some people may be allergic to one or more of the components. Patients who have an allergy to any type of drug should inform their doctor before taking any medication.
Anyone who uses this medication for therapeutic purposes on a regular basis should get their blood pressure checked on a regular basis.
As a drug of abuse
Ketamine is most commonly seen in the context of a dance club, when it is taken as a party drug. It causes a sudden high that lasts for approximately an hour in most people. It is common for users to experience feelings of euphoria, floating, and other “out of body” sensations. It is typical to get hallucinations that are similar to those experienced when taking LSD.
According to the most recent data available, 1.4 percent of 12th graders admitted to using ketamine for recreational purposes in 2014. This was a decrease from 2002, when 2.6 percent of those polled said they used it.
The following are examples of street names:
- Cat Valium
- KitKat
- Special K
- Vitamin K
- The horse tranquilizer
- Ket
- Purple
- Super K
- Jet
Various methods of administration include oral administration as a pill, snorting, smoking with tobacco or marijuana, or mixing it into liquids. The most common preparation is to boil it into a white powder for snorting. It can cause severe nausea and vomiting if taken orally.
Regardless of how it is consumed, its effects begin to manifest within a few minutes and persist for less than an hour at the maximum.
Users who take higher quantities may have more acute symptoms described as being in the “K-hole,” in which they are unable to move or communicate and feel as if they are physically separated from their bodies.
Some users actively seek out this type of transcendental experience, but others find it unsettling and consider it to be a negative side effect of the medication.
Adverse effects
The following are examples of unintended consequences:
- addiction
- psychosis
- amnesia
- impaired motor function
- high blood pressure
- respiratory problems
- seizures
Because ketamine abusers might become inattentive to their surroundings, they are at risk of injuring themselves or being assaulted by other people when abusing the drug.
Problems with coordination, judgment, and the bodily senses might last for up to 24 hours from the onset of the condition. If a person is using ketamine in a recreational situation, they should be accompanied by a sober friend to ensure their safety.
Bladder and kidney difficulties, stomach pain, and memory loss are all possible long-term consequences.
In the case that addiction and dependence develop, there is a risk of depression as well.
Ketamine abuse, whether legal or illicit, can result in serious mental disorders as well as significant physical injury to the bladder, which is known as ketamine-induced ulcerative cystitis.
Ketamine and alcohol
According to the World Health Organization, ketamine poisoning alone is unlikely to result in mortality. In contrast, combining it with other medications, such as alcohol, might amplify its sedative effects, increasing the risk of an accidental overdose.
In the United States, 1,550 trips to the emergency department (ED) were attributed to illegal ketamine usage, with 71.5 percent of these visits involving alcohol.
Overdose
Because there is only a little difference in dosage between achieving the desired benefits of the drug and overdosing in the case of a recreational user, the risk of overdosing is significant.
Addiction
Ketamine is classified as a controlled substance under the Controlled Substances Act (CSA). Long-term use can result in dependence, tolerance, and withdrawal symptoms, among other things. Quitting smoking can cause melancholy, anxiety, insomnia, and flashbacks in some people.
The usage of ketamine by chronic users has been reported to cause them to “binge” on the drug in an attempt to relive the dissociative and euphoric effects of their first experience with the drug.
Long-term use can lead to serious consequences, some of which are deadly.
Conclusion
Ketamine is a type of anesthetic medication that is used in both human and veterinary healthcare. It is critical to distinguish between legitimate medicinal applications of a drug and non-medical, recreational uses of the same drug.
When administered by a competent medical professional, ketamine is a safe and effective medicine that has many applications.
When ketamine is abused in a recreational setting, however, the consequences for one’s physical and mental health might be unexpected. It can cause long-term psychological harm and, in extreme cases, death if not addressed promptly.
Any medication should only be recommended by a doctor who is familiar with the patient’s complete medical history
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