Ketamine therapy for mental health problems has transitioned ketamine, often known as Special K, from a popular rave drug for its tranquilizing and dissociative effects to a recognized antidepressant, gaining popularity through recent research.
This evolution raises crucial questions about the long-term effects of ketamine, particularly for those who use it recreationally or as a treatment for depression.
The tragic death of Matthew Perry, known for his role in “Friends,” has brought attention to these concerns. Perry had been receiving ketamine infusion therapy, but elevated levels in his bloodstream suggest potential excessive or recreational use, highlighting the risks of psychological addiction.
While ketamine shows promise in medical settings, it is crucial to consider the implications for recreational users.
Do the benefits of using ketamine therapy to treat depression outweigh the risks for those who also use it recreationally?
Ketamine: Dissociative Anesthetic to depression treatment
First synthesized in 1962 and approved by the FDA in 1970, ketamine was initially used to alleviate pain for American soldiers during the Vietnam War.
Dissociation, one of the most well-known side effects of the drug, refers to a temporary mental state in which a person detaches from their surroundings.
Most people know ketamine as a horse tranquilizer, but the World Health Organization lists it among its tally of “essential medicines” due to its broad use as an analgesic (painkiller).
In the 1990s, ketamine became popular among clubgoers, particularly ravers, who would often take it to experience a “K-hole,” a state of intense dissociation. This popularity led the U.S. government to classify it as a Schedule III substance, alongside steroids and Tylenol with codeine.
In 2006, the National Institute of Mental Health concluded that a single intravenous dose of ketamine had rapid antidepressant effects.
Ketamine is an important drug, particularly for treatment-resistant depression. However, long-term users who become addicted can develop severe behavioral issues and long-term brain changes and no one is immune to addiction.
Understanding How Ketamine Affects the Brain
Ketamine is often characterized as a “dirty drug” because it interacts with multiple neural pathways simultaneously, influencing a variety of functions. This wide-ranging impact underlies both its efficacy and unpredictability in managing certain conditions.
Scientists have proposed several theories about how ketamine works to combat depressive disorders. The focus is on its effects on specific brain receptors and the neurotransmitter glutamate. These interactions are believed to quickly improve mood and cognitive functions in people with depression.
However, the same characteristics that make ketamine potentially therapeutic also pose risks. Its wide-ranging impact on the central nervous system is not fully understood, making its effects unpredictable. Therefore, it is essential to carefully consider a patient’s history, symptoms, and risk factors when using ketamine to avoid unintended consequences. Ongoing research is aimed at understanding ketamine’s complex pharmacology and how it rapidly affects the neural circuits involved in depressive symptoms.
A study published in the National Library of Medicine indicates that ketamine can cause significant changes in brain function, leading to cognitive impairments such as memory problems, attention deficits, and executive dysfunction.
Ketamine therapy vs Recreational use
The primary distinction between recreational and medical use of ketamine lies in how it is administered. In clinical settings, ketamine is given intravenously, resulting in a gradual onset of effects. However, when used recreationally through snorting or oral ingestion, the drug’s delivery is much more abrupt. These alternative methods lead to lower bioavailability compared to intravenous injection, requiring recreational users to take larger doses to achieve the desired altered mental state.
The effects of ketamine taken through the nose or by mouth differ significantly from those administered through a medical IV infusion. This difference in how the drug is given and its effects highlights the distinction between its approved medical use and its dangerous recreational misuse.
At higher doses, individuals may experience derealization or detachment from reality, potentially leading to dangerous decisions and actions. Some individuals fall into what are described as “K-holes,” a state in which they become temporarily immobile and unable to adequately process external stimuli, often appearing unresponsive to outside influence. This condition, frequently accompanied by hallucinations and psychosis, can persist for extended periods before the affected person recovers normal mental and physical functioning.
There have been reports of cases where individuals took hours to get back to reality from a K-hole state.
The long-term health impacts of recreational ketamine use are not yet fully understood. Even occasional utilization, such as once per month or once per year, may result in lasting consequences, though the precise outcomes have not been definitively determined. Further research is warranted to more comprehensively evaluate potential chronic effects from both short and long-term ketamine exposure.
How Does Ketamine Change the Brain?
A Columbia University study published in Cell Reports found that repeated use over an extended period leads to widespread structural changes in the brain’s dopamine system. Dopamine is a neurotransmitter that affects how we feel pleasure and how we think.
Long-Term Side Effects of Ketamine on the Brain
Cognitive and Psychological Impacts
Long-term use of ketamine can lead to cognitive impairments, such as:
- memory loss
- reduced attention span
- difficulty with complex cognitive tasks
Chronic users often report experiencing ‘brain fog‘ and a decrease in cognitive sharpness, making it challenging to perform daily tasks that require concentration and critical thinking.
Moreover, the dissociative effects of ketamine, while sought after for their immediate impact, can lead to long-term psychological issues.
Users frequently find themselves increasingly detached from reality, experiencing persistent dissociation even when not under the influence of the drug. This can contribute to feelings of isolation, depression, and anxiety, further complicating the individual’s mental health.
Some users may have difficulty coming out of their state of dissociation and may continue to feel disconnected from the world around them even after they stop using ketamine.
Schizophrenia-like Symptoms from Extensive Ketamine Use
Extensive overuse of ketamine can lead to symptoms resembling schizophrenia. These include hallucinations, paranoia, and severe cognitive disturbances.
A study in the Journal of Psychopharmacology reported that heavy, long-term ketamine users exhibited significant impairments in working memory, verbal memory, and executive function, which are hallmark symptoms of schizophrenia.
Memory Impairment and Cognitive Decline from Chronic Use
Long-term use of ketamine produces chronic impairments within the area of the brain associated with memory. Ketamine abusers have been noted to have difficulty creating memories, accessing old memories, and experiencing problems with spatial, short-term, and visual memory.
Ketamine For Depression Treatment
Telehealth Ketamine Therapy
Telehealth ketamine therapy has gained popularity in the age of social distancing, where some clinics prescribe ketamine tablets for patients to take at home while they video chat with a clinician. This method offers a convenient and accessible way for patients to receive treatment, particularly those with severe depression who may struggle to attend in-person appointments.
FDA issued a warning about this procedure that;
“Patients who receive compounded ketamine products from compounders and telemedicine platforms for the treatment of psychiatric disorders may not receive important information about the potential risks associated with the product,”
Esketamine Nasal Spray
Another way of taking ketamine therapy is through a nasal spray that can be prescribed for home use as a treatment for depression or other mental health issues. This spray is made of a type of ketamine called esketamine, which is different in molecular structure but has the same effects as the ketamine you typically hear about.
Unsurprisingly, some have appropriated esketamine spray as a party drug, with ravers preferring the smaller, more controllable doses. However, this misuse can lead to significant risks, including addiction and severe mental health issues.
Long-Term Side Effects of Ketamine for Depression
While ketamine therapy shows promise in treating depression, long-term use can hinder judgment, attention, and thinking. It can exacerbate existing mental health problems such as depression.
Research shows that chronic users of ketamine tend to be more depressed than occasional users.
It is, therefore, important for individuals with depression to avoid taking ketamine outside of low-dose therapeutic treatments administered under the direct supervision of a doctor.
If you are suffering from depression, consider talking to your doctor about medical and non-medical ways of treating depression. It is important to be aware of the dangers associated with taking ketamine while depressed and to seek help if you currently use ketamine and are finding it difficult to quit.
Mental Health & Drug Abuse
Research findings suggest that individuals suffering from mental health conditions are significantly more prone to developing substance use disorders. According to the National Institute on Drug Abuse (NIDA), approximately half of those experiencing a mental illness will also experience a substance use disorder, and vice versa. Depression, as one of the most prevalent mental health disorders, plays an important part in this co-occurrence.
Get Help For Depression and Substance Abuse
If you or someone you know is struggling with a mental health condition or substance abuse, don’t wait to seek help.
At Still Behavioral Health Group, we are dedicated to providing a safe haven for mental health and addiction recovery. Our Drug & Addiction Treatment Facility Still Detox in Boca Raton and Still Mind Mental Health Clinic in Fort Lauderdale offer compassionate care and tailored treatment plans to support your recovery and wellbeing.
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Long-Term Physical Side Effects of Ketamine
Damage to Nasal and Sinus Cavities
When ketamine is ingested nasally, it can damage the nasal passageways and sinus cavities. The long-term effects of snorting ketamine include damage to the structure of the nose as well as an impaired sense of smell. Chronic users often develop rhinitis and sinusitis, conditions that cause persistent nasal congestion and discomfort.
Vein and Tissue Damage from Injection
When injected, ketamine can damage veins, muscles, skin, and internal organs. It can also lead to skin infections, infectious diseases, or endocarditis, an infection of the heart valves. Long-term intravenous users may develop track marks, abscesses, and severe skin infections that can require medical intervention.
Urinary Tract and Bladder Problems
Chronic ketamine use has also been known to damage the kidneys and liver. When high doses of the drug are taken for an extended amount of time, this can lead to urinary tract and bladder problems. Ketamine-induced ulcerative cystitis also known as “ketamine bladder” is a condition characterized by severe bladder pain and frequent urination.
Studies have shown that up to 30% of heavy ketamine users develop some form of urinary tract dysfunction, which can severely impact their quality of life.
Cardiovascular and Respiratory Issues
An increased heart rate, seizures, high blood pressure, and respiratory issues may also be experienced. These symptoms can escalate into life-threatening conditions, particularly in users with pre-existing cardiovascular or respiratory conditions.
Is ketamine legal?
In the United States, ketamine is classified as a Schedule III drug, meaning it has a moderate to low potential for physical and psychological dependence. It’s perfectly legal for use in medical settings, where it’s commonly employed as an anesthetic. Ketamine clinics that offer IV infusions or injections are operating within the law, and patients who use prescribed esketamine spray are also doing so legally.
However, it’s still illegal to possess or sell ketamine outside of medical settings. If someone is caught with small amounts of ketamine, they typically face a misdemeanor charge, which can lead to a fine and up to a year in county jail. On the other hand, the illegal manufacturing or sale of ketamine can result in much harsher penalties, including fines up to $2.5 million and prison sentences of up to 15 years.
