Ketamine Overdose Symptoms, Treatment & Long-Term Outlook

They will emphasize that while under the effects of ketamine, you will learn to view drug use in a more negative light and sobriety in a more positive light. Studies have shown that people with alcohol or heroin addictions are less likely to relapse under ketamine therapy. Ketamine is a dissociative hallucinogenic tranquilizer that causes the user to experience a full-body buzz resulting in a pronounced sense of relaxation.

Figure 2. Molecular Targets of Rapid-acting Antidepressants (RAADs).

A recent study has shown that ketamine can cause a decrease in acute suicidal ideation for at least six weeks when used as an adjunct therapy with anti-depressant therapy 1. The researchers hypothesize that this increased length of efficacy is due to the participants remaining on their antidepressants during this study. Ketamine’s duration of efficacy for treatment of acute suicidal ideation should be further researched before more concrete conclusions can be made.

Adverse effects and risks

To better understand the neurobiology of depression and RAADs, numerous clinical biomarker studies over the past decade capitalized on the RAAD effects of ketamine, its potent effects on prefrontal glutamate neurotransmission, and its robust neuronal remodeling 24h post infusion. Here, we will briefly review biomarker studies of relevance to the ketamine induced acute glutamate surge (i.e., during infusion) and sustained neuronal remodeling (i.e., 24h post treatment). The role of the transient postsynaptic glutamate activation in the RAAD effects of ketamine has been abundantly shown in preclinical studies. First line of evidence stems from a consistent observation that the inhibition of postsynaptic glutamate activation – using AMPAR antagonists – blocks the synaptic remodeling and https://ecosoberhouse.com/article/social-drinking-and-drinking-problem/ the RAAD effects of ketamine (N. Li, et al., 2010; S. Maeng, et al., 2008). Here, we note that even selective AMPAR antagonists will presumably block overall postsynaptic glutamate activation through inhibition of both AMPAR and NMDAR, considering that AMPAR activation leading to membrane depolarization is required for NMDAR signaling. In this context, most of the evidence relating AMPAR blockade to the inhibition of RAADs would be considered an indication of the need for postsynaptic glutamate activation rather than specific AMPAR activation.

What Is Ketamine?

Due to its euphoric, dissociative, and hallucinogenic properties, ketamine has been abused as a recreational drug, which has led to rigid regulation of medication. The COVID-19 pandemic has been an unprecedented challenge for the American population which was reflected in increased reports of problems regarding their mental health. Approximately one in ten people stated that they had started or increased substance use because of the COVID-19 pandemic. Furthermore, rates of suicidal ideation have significantly increased when compared to pre-pandemic levels, with more than twice the number of adults surveyed in 2018 indicating suicidal thoughts “within the last 30 days” at the time they were surveyed. Results of this review indicate that ketamine’s therapeutic effects offer a potential alternative treatment for depression, suicidal ideation, substance use disorders, and PTSD.

Ketamine Treatment for Depression: Worth a Try?

• Two clinical trials — one looking at cocaine addiction and the other at alcohol dependency — showed that people who were prescribed ketamine, alongside therapy, had a better outcome than those who had therapy without ketamine treatment.
• Because of esketamine’s ease of use, it can be self-administered by patients outside of a clinical setting.
• Other off-label uses of ketamine include treating bipolar disorder, post-traumatic stress disorder, as well as substance use disorder.

Cognitive behavioral therapy can assist with changing the thought patterns that play a role in supporting drug use and addiction. This leaves plenty of room for excessive amounts of ketamine to be taken, amounts which can lead to an overdose. Likewise, snorting and injecting ketamine are common ways to consume ketamine, so this permits quick entry into the bloodstream. Ketamine can disrupt the senses, judgment, and motor function for up to 24 hours after use.

• However, in the studies reviewed here, this is not consistently observed; for instance, in the study by Dakwar et al,104 more individuals dropped out from the midazolam group and returned to heavy drinking compared with the ketamine group.
• Ketamine is a dissociative hallucinogen that distorts the way people perceive sights and sounds.
• Ketamine is classified as a Schedule III controlled substance, meaning it has a moderate to low potential for physical and psychological dependence.

Data Availability Statement

The purpose of this narrative review is to identify recently published studies that describe the therapeutic uses of ketamine for mental health. Following the regimen used in the first study (Berman, et al., 2000), clinical trials have mostly administered 0.5 mg/kg intravenous (i.v.) ketamine infused over 40 minutes reviewed in (Abdallah, Averill, et al., ketamine addiction 2015). To date, there is well replicated evidence showing the RAAD effects of a single ketamine infusion in MDD (McGirr, et al., 2015). Concerns regarding the efficacy of the treatment blinding were partially addressed using active placebo (Murrough, et al., 2013).

• Future studies should assess and report on concurrent use of FDA-approved treatments for opioid use disorder (both at baseline and in the follow-up phase).
• People who use ketamine regularly can develop a tolerance to it, which could lead to them taking even more to get the effects they’re looking for.
• There is a growing body of evidence telling us that ketamine could be a powerful tool for people struggling with addiction.
• Injecting ketamine involves using a liquid form of ketamine and injecting the drug into a vein or muscle (intramuscular) using a syringe and needle.
• This can contribute to the cycle of ketamine misuse and addiction, prompting the individual to continually seek out the drug despite negative consequences.
• Where possible, the support of friends and family is also fundamental when recovering from ketamine addiction.