Ketamine induces an experience of dissociation to varying degrees depending on dosage and route of administration. Dissociation refers to a feeling of disconnection from our body and normal sense of reality. This experience is highly individualized, but many people report changes in both their perception of time and space, and an experience of being an outsider looking in, or witnessing their thoughts from a distance.
Ketamine has been widely used as an anesthetic since the 1960s, in amounts much higher that what is used even in the highest doses within a ketamine assisted therapy context, without respiratory depression or cardiac complications. The safety profile of ketamine is robust enough that it is often the first choice of anesthetic to be used in the treatment of children and within an emergency medicine context. Before beginning ketamine therapy, a thorough medical clearance exam is required to assure that ketamine is a safe choice for you as an individual.
Varying with route of administration and your personal therapeutic needs, an induction period of 4-6 weeks of weekly or biweekly treatments is recommended to bolster the antidepressant and neuroplastic effects of ketamine. Length of ketamine therapy is highly individualized. It is safe and within your ability to withdraw from ketamine therapy at any time, without a withdrawal period as is often the case with traditional antidepressants.
Before participating in ketamine treatment, you will be carefully interviewed to determine if you are eligible for ketamine therapy, including a medical and psychological history. Pregnant women and nursing mothers are not eligible for ketamine treatment. Untreated hypertension is a contraindication to ketamine use as it causes a rise in BP. Similarly, a history of heart disease may make you ineligible to participate.
Ketamine does not cause tolerance and withdrawal symptoms and therefore does not meet the criteria for chemical dependence. However, “cravings” have been reported by individuals with the history of heavy use of “psychedelic” drugs.
Due to the nature of the ketamine experience, there is the possibility of psychological dependence if large amounts of ketamine are used for an extended period of time without the oversight of a licensed physician. These amounts are generally much higher than what is prescribed or administered during ketamine therapy. Ketamine is a schedule III controlled substance, and should never be used without with oversight.
The side effects of ketamine may include dizziness, a change in depth perception, nausea/vomiting, blurred vision, slurred speech, euphoria, confusion, anxiety, and a change in perception of time and space.
A rise in blood pressure may also occur when using ketamine. For this reason, uncontrolled hypertension is a contraindication for ketamine therapy.
Repeated, high dose, chronic use of ketamine has caused urinary tract symptoms and even permanent bladder dysfunction is individuals abusing the drug. This has not occurred within this framework of treatment and at the doses used in ketamine assisted psychotherapy.
In many people, the effects of ketamine are experienced during a session, immediately after, or within a day of their first dose. However, it is possible for these effects to fade 5-7 days following treatment; this is one reason why a 4-6 week period of weekly sessions is recommended to begin treatment.