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What is Ketamine? | Chemistry, Use Cases, Dosage & Side Effects

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Ketamine is a fascinating drug that has generally been used for anesthetic purposes in animal and human medicine, yet it is increasingly finding its way into the realm of mental health treatments. 

This single molecule can have profound effects on patients experiencing depression, anxiety, PTSD, chronic pain, and other major mental disorders – sometimes working where nothing else will. 

In this blog post, we’ll take a closer look at ketamine’s chemical structure and mechanism of psychoactive action on the body as well as discuss how it is currently being used medicinally both within and outside of traditional healthcare systems.

We’ll also dive into some important safety considerations including dosage guidelines, side effects to watch out for, and potential long-term risks associated with use.

Chemical Composition 

Legal Status 

Identifiers 

C13H16ClNO Schedule III controlled substance CAS Number 6740-88-1

PubChem CID 3821

Ketamine High-Level Fact Sheet

If you are considering taking or have been prescribed Ketamine for a medical condition, it is important to familiarize yourself with the basic information about the drug. In this high-level fact sheet, we will discuss the chemical structure, legal status, and pharmaceutical identifiers of Ketamine.

Ketamine Chemical Composition

Ketamine is a dissociative anesthetic and hallucinogenic drug that has the chemical name 2-(2-chlorophenyl)-2-(methylamino)cyclohexanone. Its chemical formula is C13H16ClNO.

Ketamine Legal Status 

Ketamine is considered a Schedule III controlled substance in the United States, meaning it has some accepted medical uses but can also easily lead to abuse. It is legally available with a prescription from a licensed healthcare practitioner. 

Ketamine Clinical Data

Ketamine is classified as an NMDA receptor antagonist and works by blocking certain nerve receptors in the brain, altering consciousness, and producing hallucinogenic effects. This mechanism lends Ketamine its tendency to cause dependence or addiction.

Among its many street names, ketamine is sometimes referred to as “Special K” or “Vitamin K.”  Its primary trade name is Ketalar; other names include Ketanest, Ketaset, and Ketavet.

Ketamine Use Cases:

While the therapeutic pharmacological properties of Ketamine have been known since the 1960s, its use cases are varied, and now will explore the three primary ways in which ketamine is used… to treat medical disorders, for performance enhancement, and recreationally. 

Medical: 

Ketamine has been used as an anesthetic since the 1970s. It is commonly used in emergency rooms to sedate patients who are unresponsive or agitated due to extreme pain or shock. It is also frequently given to children during surgical procedures, as it has fewer side effects than other anesthetics. 

Ketamine has also been used to treat a variety of medical conditions such as depression, anxiety, PTSD, chronic pain, and even addiction. It is an FDA-approved medicine for difficult-to-treat depression that can provide rapid relief from symptoms within hours or even minutes after administration.

Performance Enhancement:

Ketamine has recently become popular among athletes as a performance enhancer. A study found that low-dose infusions of ketamine improved reaction time and cognitive flexibility in healthy volunteers. 

This effect was attributed to its ability to reduce stress and fatigue, allowing athletes to focus more easily on intense tasks such as weightlifting or running marathons.

However, long-term use of ketamine for performance enhancement can lead to serious health risks such as liver damage or addiction, thus it should only be used with caution under the guidance of a healthcare professional. 

Recreational:

Ketamine is also widely used recreationally by people looking for a “high” or altered state of consciousness. When abused in large doses, ketamine can cause hallucinations and out-of-body experiences that users find pleasurable but can lead to dangerous behavior due to impaired judgment and motor skills impairment. 

Those who use Ketamine as a party drug often report experiences ranging from mild visual disturbances like color changes to more intense hallucinations involving sound or touch.

Ketamine dosages by form and strength:

Ketamine is a general anesthetic used in medical and veterinary settings to induce loss of consciousness and provide analgesia. It is available in various forms and strengths, ranging from intramuscular (IM) injections to intravenous (IV), intranasal, oral, and topical formulations. 

The strength of ketamine can vary depending on the form and the manufacturer.

Injectable solution

Ketamine is typically available in a concentration of 100 mg/mL or 50 mg/mL. The injectable solution is usually administered in a hospital or clinical setting by a healthcare professional.

Nasal spray

In some countries there is a Nasal spray called Esketamine available which is typically available at the strength of 100 mg/device with each pump delivering 10mg of ketamine. 

Oral tablets

Ketamine is not available in oral tablets on regular basis but there might be some compounding pharmacies that provide oral tablet forms ranging from 50-300 mg.

Ketamine Side Effects:

As with any drug, there can be potential side effects associated with the prolonged use of Ketamine even for medical purposes. To help you understand, we have broken categorized these as common, serious, and long-term side effects of ketamine. 

Common Side Effects on Ketamine:

When consumed in smaller doses, especially for recreation, the most common side effects of ketamine include:

  • Confusion
  • Dizziness
  • Slurred speech
  • Delayed reflexes
  • Memory loss
  • Double vision or blurry vision
  • Increased heart rate and blood pressure
  • Feeling out of touch with reality or as if you’re dreaming while awake (dissociation)
  • Sense of detachment from your environment or yourself (depersonalization)
  • Depression
  • Rapid eye movements

Serious Side Effects on Ketamine: 

Though rarer than the common side effects listed above, some people have experienced more serious reactions to ketamine including

  • Cognitive impairment 
  • Dreamlike states (hallucinations)
  • Sedation followed by agitation  when the drug wears off 
  • Confusion
  • Loss of memory
  • High blood pressure
  • Unconsciousness
  • Slow Breathing

Ketamine Long Term Effects:

Long-term use of ketamine has been linked to cognitive deficits such as memory loss and difficulty concentrating. Additionally, chronic misuse can lead to addiction and substance abuse disorder. 

This could also increase the risk ulcers and pain in the bladder, kidney problems, abdominal pain, and depression.

It’s important to remember that these side effects will vary from person to person, and may be more severe or longer-lasting in some individuals than others.

Ketamine Addiction: 

Ketamine is a dissociative anesthetic drug with hallucinogenic properties that are reported to provide a euphoric, out-of-body experience. While many regard this as a positive experience, using ketamine frequently can quickly lead to physical and psychological dependence due to the drug’s powerful effects on the brain. 

Those who become addicted to ketamine may find it difficult to break away from the drug, suffering from depression, anxiety, and other mental health issues as a result of their use. Sadly, ketamine addiction can lead to permanent damage to the brain, as well as physical dependence on the substance that requires professional treatment. 

The sooner someone struggling with ketamine addiction gets help, the better chance they have of making a full recovery.

Types of Drug Treatment for Ketamine Addiction

Ketamine has the ability to rapidly create an intense high and therefore can be habit-forming. For individuals struggling with addiction to this powerful drug, specialized treatment is necessary. 

Treatment for Ketamine addiction should focus on both helping a person abstain from the use of ketamine in the long term and also helping them modify the important areas of their life which may have encouraged or enabled their addiction. 

There are a variety of effective therapeutic models that can be used for successful recovery. These include cognitive behavioral therapy, individual and group counseling, 12-step programs as well as a medication-assisted treatment where appropriate. 

A combination of these methods offers the greatest opportunity for success when it comes to overcoming an addiction to ketamine.

Ketamine Withdrawal:  

Ketamine withdrawal is a physical and psychological response experienced by people who have become physically and/or psychologically dependent on the drug, usually after long-term use. 

This condition is known as ketamine dependence and can cause various symptoms that range from mild to more intense, depending on how much was used and for how long. The most common signs of ketamine withdrawal include anxiety, irritability, cravings for the drug, insomnia, mood swings, depression, fatigue, and increased heart rate.

Commonly Seen Ketamine Drug Combinations: 

Due to its unique psychoactive effects, Ketamine is also used in combination with other substances to create even more intense experiences. Ketamine and alcohol are commonly used together to produce powerful disinhibition of behavior and speech, stimulate intense euphoria and reduce inhibitions. This combination can be especially dangerous as both these drugs are central nervous system depressants. 

This means the effects of both substances can be amplified leading to an increased risk of drowsiness, confusion, and disorientation, which can be dangerous and impair your ability to make safe decisions. In severe cases, it can also result in respiratory depression.

Ketamine is often combined with MDMA (aka ecstasy) for an enhanced sense of pleasure, reduced physical pain, and increased feelings of warmth or tingling sensations all over the body. Combining ketamine and MDMA is generally not recommended due to the increased risk of negative side effects and dangerous reactions since both drugs are depressants.

Another famous combination is ketamine and heroin. which can be dangerous because it increases the risk of respiratory depression. Both ketamine and heroin can cause cognitive impairment and dangerously slow breathing, thus combining them can lead to an increased risk of accidents or injury. 

Lastly, Ketamine plus cannabis can result in an intense psychedelic experience due to the dual effect of combining two dissociatives in one dose; however side effects like paranoia or hallucinations can occur if taken in larger amounts. 

It is important to remember that any type of drug combination should be approached cautiously because they can increase your risk for potential health complications – including dangerous life-threatening ones – so it’s best practice not to experiment without proper medical guidance first.

Ketamine Facts and Statistics:

Due to its hallucinogenic properties, Ketamine use is quite common in clubs and party settings. While it has a low potential for addiction, long-term use can lead to physical and psychological dependence. 

According to studies, the risk of developing a substance use disorder from ketamine use is estimated to be between 2-9%. According to the National Survey on Drug Use and Health (NSDUH), in 2019, an estimated 5.6 million individuals aged 12 or older had used ketamine in the past year. This represents 2.1% of the population. 

The Substance Abuse and Mental Health Services Administration (SAMHSA) reported that in 2019, there were about 4,600 emergency department (ED) visits involving ketamine. Moreover, the deaths caused by Ketamine overdose have increased by 28% since 2020, as per a recent 2021 survey published by the U.S. Centers for Disease Control and Prevention.

All of this indicates that more research should be conducted on the risk and effects of prescribing Ketamine as an anesthetic or treatment drug for substance abuse disorder.

Ketamine History and Cultural Impact: 

Ketamine was first synthesized in 1962 by Calvin Stevens, a scientist at Parke-Davis (which was later acquired by Pfizer). It was initially developed as a surgical anesthetic, and it is still used in this capacity today. In the 1970s and 1980s, it was also used as a recreational drug, particularly in the club and rave scenes.

Ketamine has a reputation for causing hallucinations and dissociative effects, which has led to it being used as a party drug and a tool for self-exploration. It has been the subject of several movies and books, including the 2004 film “K-Pax” and the 2011 book “Ketamine: Dreams and Realities.”

Prominent personalities associated with ketamine include Lamar Odam, a former NBA star who recently opened up about using Ketamine to treat his addiction. There are also many activists and scientists who are actively working on exploring the therapeutic use of Ketamine including, Rick Doblin, the founder of the Multidisciplinary Association for Psychedelic Studies (MAPS), which has been involved in research on ketamine as a therapeutic agent.

Ketamine Identifiers 

Given below is the list of Ketamine identifiers:

Identifier Name

Identifier Code

CAS Number 6740-88-1

33643-46-8 (esketamine)

33643-49-1 (arketamine)

HCl 1867-66-9
PubChem CID 3821
IUPHAR/BPS 4233
DrugBank DB01221 
ChemSpider 3689 
UNII 690G0D6V8H
KEGG D08098
CHEBI 6121 
ChEMBL 742 
ECHA InfoCard 100.027.095

Bottom Line: Ketamine in the United States 

Ketamine is a powerful drug with many beneficial applications but there are serious risks associated with its use—both medical and recreational—which must be taken into account before considering its use. 

When administered properly under medical supervision by professionals, one can minimize potential side effects while reaping its maximum therapeutic benefits.

Warren

Warren Phillips

Warren is a Licensed Master Social Worker, who specializes in substance abuse and mental health treatment. Clinically, Warren has developed a therapeutic skillset that utilizes a strengths-based perspective, Twelve Step philosophies, Cognitive Behavioral Therapy and Motivational Interviewing.

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