What Is Ketamine Used for in Physical and Mental Health Care?

Ketamine is a short-acting general anesthetic that’s been around since the 1970s. It was first used in the United States for sedation and pain management during the Vietnam War. It continues to have many medical uses today.

The drug is also popular for recreational use because of its dissociative effects. According to the Drug Enforcement Administration (DEA), recreational forms of ketamine are commonly known as Special K, KitKat, Vitamin K, and other slang terms.

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.

In this article, we’ll discuss ketamine’s medical uses, side effects, and more.

Ketamine is known as a dissociative anesthetic. Research from 2018 suggests ketamine may work by binding to the N-methyl-D-aspartate (NMDA) receptor in the brain to block glutamate.

Glutamate is an important neurotransmitter, a kind of brain chemical that plays a role in typical brain function. Researchers believe this activity helps with ketamine’s uses in anesthesia, pain management, and depression treatment.

Ketamine also has partial effects on other brain receptors, including receptors for:

Scientists are still studying how ketamine’s interaction with these brain chemicals affects the body. But some research from 2014 shows ketamine’s interactions with these brain receptors may play a role in its pain management, anti-inflammatory, and antidepressant effects.

Some other effects of taking ketamine include:

The dissociative effects are one reason ketamine is popular as a “club drug” for recreational use.

Ketamine has different doses and dosage forms. The effects of the drug can vary depending on the dose and form, as well as whether you’re using it illegally.

Medical use dosage forms

Ketamine is a fast-acting general anesthetic. It’s available as an injection directly into a vein for sedation. This is known as an intravenous injection. It can also be used by intramuscular injection into a muscle.

Esketamine (Spravato) is a form of ketamine available as a nasal spray. It’s used along with an antidepressant to treat treatment-resistant depression in adults.

According to a 2014 review, ketamine for medical purposes is only used under the direct supervision of a trained health professional. Your doctor will not prescribe any form of ketamine for you to use on your own.

Recreational use dosage forms

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.

According to reviews from 2020 and 2021, ketamine is approved by the Food and Drug Administration (FDA) for use as a short-term injectable anesthetic in humans and animals for sedation. It works rapidly (within 10 to 30 seconds) when given intravenously for anesthesia. You can receive it alone or with other medications.

It’s also used off label for several other conditions. According to 2016 researchone of its uses is as pain management for:

Off-label use means that your physician is using the drug for a purpose other than its approved use in anesthesia. However, more data is needed to understand the drug’s safety and effectiveness for some types of pain management, especially for long-term chronic pain.

A 2018 review has shown ketamine may also be effective for treating substance use disorders, such as alcohol, cocaine, or opioid use disorder. But its benefits, dosages, and safety for long-term use need further research.

Reviews from 2018 and 2020 show that ketamine has gained popularity for its effectiveness in treating certain mental health conditions, such as major depressive disorder and suicidal ideation, along with psychotherapy.

One advantage of ketamine over other antidepressant medications is how fast it works. A 2020 review suggests it may work within 2 hours. Traditional antidepressants can take weeks to start working.

Research from 2018 and 2021 has shown ketamine’s advantages in treating conditions like:

But there is still much to learn about how ketamine works, which dosages are effective, and how safe it is.

A form of ketamine known as esketamine nasal spray was approved by the FDA in 2019 under the name Spravato for use in treatment-resistant depression. The drug is given under medical supervision.

Another form of ketamine called R-ketamine is currently being studied for treatment-resistant depression.

Side effects of ketamine depend on several factors.

They include:

  • the type of drug (medical or recreational)
  • how it’s used
  • medication given
  • your age
  • other health conditions you may have, like high blood pressure or heart disease
  • Other medications you may be taking

Side effects can vary from person to person, but are known to include:

  • nausea or vomiting
  • dizziness
  • muscle spasms or stiffness
  • urinary problems, like painful, difficult, or frequent urination and loss of bladder control
  • confusion
  • heart-related problems, like arrhythmia, slow heart rate, high blood pressure, heart failure, or cardiac arrest
  • seizures
  • eye problems
  • anxiety
  • hallucinations
  • insomnia
  • addiction
  • trouble breathing
  • Allergic reaction, including rash, trouble breathing, and swelling of the tongue, lips, or face

A 2022 review found that long-term, high dose use of recreational ketamine may be linked to brain function-related side effects, mood disorders, and psychotic symptoms.

Recreational ketamine may be used alone or mixed with other illegal substances. Because of this, it’s unclear if ketamine alone or a combination of other factors contributed to cognitive and behavioral side effects in studies.

Scientists are still learning about the long-term effects of ketamine, but they may include problems with:

It depends. If you have insurance, ketamine used for anesthesia may be covered. But injectable ketamine for depression or other mental health conditions is not yet FDA-approved and may not be covered. It’s considered an off-label use of the drug.

However, things are changing and there may be promising news in the future regarding insurance coverage. If the FDA approves ketamine for other conditions based on new research, your insurance plan could cover ketamine in the future for treatment-resistant depression and other conditions.

Insurance plans consider several factors in determining coverage. These include:

  • what condition ketamine is being used to treat — uses not approved by the FDA likely won’t be covered
  • the individual plan
  • the formulation (esketamine is covered by many plans)

If your doctor discusses ketamine as a treatment option for your health condition, you can ask them about insurance coverage. You can also check with your individual plan regarding coverage.

A lot of new research is currently being done on the various effects of ketamine. This includes benefits for mental health conditions such as treatment-resistant depression, PTSD, and suicidal ideation.

If you have certain health conditions, such as high blood pressure or heart-related problems, or certain mental health conditions, such as schizophrenia, ketamine may not be safe for you. Your doctor can tell you about the latest research and medical uses for ketamine, including the pros and cons of the drug.

Keep in mind that ketamine has serious side effects which can be dangerous. Don’t use ketamine on your own without medical supervision. 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.

Ask your doctor for more information about ketamine and its uses.

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