“Isn’t that horse tranquilizer?” is a typical question you may encounter when bringing up ketamine to someone for the first time. The less likely response you can expect is ‘the drug used to treat depression?’. It is, yes, traditionally used to sedate horses, or at least that’s where its origins reside. It has also been used as a party drug since the 80s as well as, in some special cases, a way to sedate human patients especially in the event of attempted suicide or other stressful episodes. Special K, Vitamin K and Kit Kat are just some of the many names that this drug is referred to on the streets. While this drug has a long history that spans diverse contexts, as of late ketamine therapy been making headlines in the field of clinical psychology.
Is Ketamine a Psychedelic?
Although considered to be a psychedelic by some, it is technically considered to be a dissociative anaesthetic. Because of that ketamine operates differently than more traditional psychedelics, like LSD or psilocybin, even though it may produce some similar effects. While a true psychedelic experience often comes with some challenges and intensity, ketamine offers a comparatively uplifting and gentle effect, which is particularly useful in a clinical setting. This is probably why it makes for a great therapeutic tool when used in the right context. A single dose is processed quickly by the body, creating a short and typically positive experience. This is much more doable and tolerable for man people than committing to a several-hour psychedelic journey. (Want to learn more about other psychedelic therapies? Check out Everything you need to know about psychedelic therapy)
What We Know About Ketamine
This may come as a surprise to many, but we have known its impacts on depression and even suicidal tendencies for decades. In the 70s, ketamine was approved as an anesthetic for treating soldiers in the Vietnam war. It is a powerful dissociative, meaning it has the capability to separate the cognition from the physical body, to a certain degree. Dissociation can mean letting go of the concept of time, a feeling of detachment from the surrounding environment, and even moments where the body itself feels different or foreign. This is perfect if someone has lets say, just suffered a gunshot wound. In a sub-anaesthetic dose, it is very capable of pulling the mind out of repetitive and automatic thought patterns.
After the war, ketamine gained legs as a sedative in emergency situations, like when someone is attempting suicide. It was within these applications that some unique results became apparent. Patients who received a dose reported that their depression, and their suicidal thoughts, disappeared for some time, sometimes for even months.
What Is Ketamine Therapy?
Ketamine isn’t the first counterculture illicit drug to turn into a therapeutic tool (if you would like to learn more about the history of other psychedelics used in therapy, check out A Brief History of LSD Psychedelic Therapy). In the past two decades, there have been a number of studies done on the effectiveness of ketamine on certain psychiatric disorders, and many of the results have been quite positive, especially when it comes to treating depression.
In 2019 the results of one study indicated that ketamine has a fast-acting ability to provide relief to those suffering from depression. Six doses were administered to male patients with chronic depression over the course of two weeks. Now, anything that promises a single treatment to cure depression is likely a bit far fetched, however the first dose of ketamine was often enough to significantly reduce feelings of depression and anxiety for many.
Another study, published in the Journal of Psychoactive Drugs dating back to 1997, reported the benefits of ketamine-assisted therapy on alcoholic patients. This ten year study concluded that in most cases it was a beneficial treatment that brought on positive transformation towards one’s life purpose, values, spirituality and their sense of self. These changes all proved to be profoundly influential in encouraging and maintaining a sober lifestyle. In other words, ketamine therapy provided a life-changing perspective.
In each study the therapy is administered differently, but the results were similar - small doses are all that is necessary to be beneficial. The jury is still out on whether or not higher doses have a greater impact, but it is generally thought that a low dose has just as much effect (if not more) and with less risk to the physical health of the patient.
Is Ketamine Addictive?
You might be thinking: ‘Where can I get this magical drug?’ Before you get carried away, it is imperative to mention that ketamine doesn’t come without side effects. Low doses of ketamine can result in perceptual distortions of time and space, hallucinations, and mild dissociation. At higher doses, it can cause severe dissociation (known to some as a K-Hole) where a person may feel completely divorced from reality and their body. Some describe it as an out-of-body or a near-death experience, entering another reality and even encountering aliens. While these sensations may be appealing to some, taking too much ketamine can also lead to memory loss, panic, anxiety, and psychosis. In the wrong context, like an incorrect dosage and especially in the presence of alcohol, it can even be deadly. There are also reports of ketamine triggering psychotic episodes. It is most certainly something that requires medical supervision and individual vetting. As is such in treating any psychological disorder, there is a protocol, therapy, and many other considerations that help to unveil its positive potential.
Even now, some doctors deem ketamine to be too dangerous to use. Its addiction potential has been long debated because of its unique pharmacological properties and the way it interacts with dopamine receptors (sort of similar to cocaine in that regard). A study published in July 2022 in an issue of Nature clarified that ketamine, despite its ability to curate happy feelings, has a low likelihood of creating addictive tendencies towards the drug.
Is Ketamine Therapy Right For Me?
This is a challenging question because any psychedelic therapy really should be administered on a case-by-case basis. Each individual comes with individual challenges and needs. Depression, for instance, can present differently across individuals and population, with elements like trauma and brain chemistry factoring into a plethora of different possibilities. If this is something that piques your curiosity, you might have to do some searching to find a doctor who is not only open to the therapy, but also experienced enough. What is for certain is that ketamine has been turning heads for long enough now to prove itself in the world of psychiatric medicine.
Research
https://www.webmd.com/depression/features/what-does-ketamine-do-your-brain
https://www.nature.com/articles/s41586-022-04993-7
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6767816/
https://www.deadiversion.usdoj.gov/drug_chem_info/ketamine.pdf