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What Is Ketamine?

Ketamine got its start in Belgium in the 1960s as an anesthesia medicine for animals. The FDA approved it as an anesthetic for people in 1970. It was used in treating injured soldiers on the battlefields in the Vietnam War. Buy ketamine Online Without Prescription

Emergency responders may give it to an agitated patient who, for example, they have rescued from a suicide attempt. That’s how Ken Stewart, MD, says doctors began to realize that the drug had powerful effects against depression and suicidal thoughts.

“Someone is trying to jump off a bridge and they give him ketamine in the ambulance to calm him down and 9 months later, he says, ‘I haven’t felt suicidal for 9 months.’

“When enough stories like that started to pile up, doctors said, ‘Maybe there’s something here,’” says Stewart, an emergency physician and founder of Insight Ketamine in Santa Fe, NM. Like the drug itself, Stewart got his start in combat medicine during the Vietnam War. Some doctors also use ketamine to treat suicidal thoughts.

Ketamine causes what doctors call a “dissociative experience” and what most anyone else would call a “trip.” That’s how it became a club drug, called K, Special K, Super K, and Vitamin K among others. Partiers inject it, put it in drinks, snort it, or add it to joints or cigarettes.

“Ketamine can produce feelings of unreality; visual and sensory distortions; a distorted feeling about one’s body; temporary unusual thoughts and beliefs; and a euphoria or a buzz,” says John Krystal, MD, chief of psychiatry at Yale-New Haven Hospital and Yale School of Medicine in Connecticut, where he is a leader in studying ketamine’s antidepressant effects.

The trip lasts about 2 hours. But there are risks of casual use. The most serious are unconsciousness, high blood pressure, and dangerously slowed breathing. The drug could also cause long-term problems, such as ulcers and pain in the bladder; kidney problems; stomach pain; depression; and poor memory. Ketamine could be fatal for people who abuse alcohol or if you take it while you’re drunk.

But the drug’s potential as a treatment for depression and antidote to suicidal thoughts has drawn researchers’ attention. They’ve studied and administered it in controlled, clinical settings to help with treatment-resistant depression and other conditions.

To be clear: Casual use is not a treatment for depression. But doctors have developed a protocol for medically supervised use that may help people who don’t get relief from other medications.

“We’re reaching out in a new way to patients who have not responded to other kinds of treatments and providing, for some of them, the first time that they’ve gotten better from their depression,” Krystal says.

Receiving Ketamine

Ketamine comes in several forms. The only one that the FDA has approved as a medication for depression is a nasal spray called esketamine (Spravato). It’s for adults who either haven’t been helped by antidepressant pills, have major depressive disorder, or are suicidal. They continue on their antidepressant and receive esketamine at a doctor’s office or in a clinic, where a health care provider watches over them for 2 hours after the dose. Buy ketamine Online Without Prescription

For treatment-resistant depression, patients usually get the nasal spray twice a week for 1 to 4 weeks; then once a week for weeks 5 to 9; and then once every week or 2 after that.

The spray has a “black box” warning about the risk of sedation and trouble with attention, judgment, and thinking, as well as risk for abuse or misuse of the drug and suicidal thoughts and behaviors.

Other forms of ketamine not approved by the FDA for mental health conditions include IV infusion, a shot in the arm, or lozenges. Most research looks at ketamine given by IV. You can only get it by IV or shot in a doctor’s office. Some doctors will prescribe lozenges for at-home use -- often to keep depression at bay between infusions.

At his clinic, Stewart only sees patients who have referrals from a doctor that diagnosed them with treatment-resistant depression. Stewart doesn’t make these diagnoses. He starts patients with a research-based six infusions spaced over 3 weeks.

“That’s how people get started,” Krystal says. “Two infusions a week, and then they go down to one infusion a week, and then most people go down to eventually one infusion every 2 to 4 weeks.”

Most research stops the initial treatment at 6 weeks. There’s no research to suggest that more than 6 weeks in a row brings more benefits, though people do go back for boosters if symptoms return.

The IV infusion lasts about 40 minutes. The dissociative experience starts quickly and takes about 15 to 20 minutes to wear off after the drip ends. A doctor is always on site during the whole process. The doctor isn’t necessarily in the room with the person being treated but is available if they need anything or become anxious or confused.

While the patient is on the drip, Stewart says, they look asleep. Most don’t move or talk. Though some, he says, may talk or make a comment about the music playing on their headphones or some part of their experience or perhaps ask where they are. Unless they need something, Stewart says, no one interferes.

Christa Coulter-Scott, a pediatric nurse from Athens, GA, got treatment in a similar setting in Gainesville, GA. She says she didn’t want to wake up. “It was like a spiritual journey. I felt warm, safe, and confident. As the treatment went on, all the weight of stress was taken off of me in layers. I felt like I had the power of the universe at my fingertips.”

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