Because street users of ketamine usually take much higher doses — while mixing it with other substances — they might experience extreme physical and psychological effects.
However, when ketamine is administered in a health care setting — such as an intravenous (IV) ketamine infusion — it is done using the correct dosage. As such, the effects are drastically different.
If you are considering being treated with an IV ketamine infusion, then learning about what to expect during treatment can go a long way in preparing you.
Keep reading this guide from Pasithea Clinics to discover how a ketamine infusion works, how it affects the brain and body, and what you can expect during your next treatment.
How Does a Ketamine Infusion Work?
At higher doses, ketamine is a powerful anesthetic. However, ketamine produces rapid antidepressant effects at sub-anesthetic doses without inducing anesthesia.
Although ketamine has many effects on the central nervous system (CNS), it primarily affects the glutamate system. Glutamate is the CNS’s primary excitatory neurotransmitter, which allows it to “activate” the cells that it acts upon.
Glutamate is responsible for various processes in the CNS. It has been implicated in the growth of new neurons, creating new connections between various brain regions, and strengthening existing connections. For this reason, glutamate is a key neurotransmitter in neuroplasticity — which is the brain’s ability to undergo profound changes.
Ketamine works by blocking the brain’s MDMA receptors, which are responsible for the reuptake of ketamine. As a result, the levels of glutamate in the brain increase. This allows glutamate to create various structural and functional changes in the brain, which can lead to significant antidepressant effects.
Ketamine can be administered orally, nasally, or through an intramuscular injection. However, an intravenous (IV) infusion has the highest bioavailability rate at 100%. For this reason, a ketamine infusion is the preferred route of administration.
The infusion lasts about 40 minutes. Although one infusion is sometimes enough to produce profound effects, a standard course of treatment is usually three weeks with biweekly infusions.
What Does a Ketamine Infusion Treat?
A ketamine infusion is most well-known for treating symptoms of treatment-resistant depression (TRD). Millions of people in the world suffer from major depressive disorder (MDD). However, almost 30% of those with MDD do not get relief from conventional antidepressant treatments.
This is partially because antidepressants are based on the monoamine deficiency hypothesis. According to it, symptoms of depression are caused by an imbalance in one neurotransmitter, such as serotonin, dopamine, or norepinephrine. As such, conventional antidepressants increase the brain’s levels of just one neurotransmitter.
Researchers are beginning to discover that MDD is a complex disorder with various structural and functional correlates in the brain. As a result, targeting just one neurotransmitter is oftentimes not effective.
By producing multiple effects in the brain, ketamine is able to rapidly produce improvements in symptoms of TRD when conventional depressants are not able to do so.
In addition to treating symptoms of TRD, ketamine infusions are shown to be a promising treatment in alleviating symptoms of post-traumatic stress disorder (PTSD), panic disorder, agoraphobia, social anxiety disorder, and chronic pain.
What Happens During a Ketamine Infusion?
What a ketamine infusion may look like depends on where it is being administered. At Pasithea Clinics, a ketamine infusion is a treatment made up of three phases: the screening phase, the treatment phase, and the post-treatment phase.
Our licensed clinicians will be with you every step of the process to ensure that the ketamine infusion that you receive rapidly, effectively, and safely alleviates your symptoms. Here is what you should expect when being treated by us:
Phase 1: Screening
Because ketamine is a schedule III controlled substance, it is important for clinicians to be prudent every administering it. While therapeutic ketamine has minimal side effects, you will still need to go through a screening process to ensure that it is the right medication for you.
You will begin the screening phase by meeting with one of our board-certified psychiatrists over a video call. In the video call, you will be able to bring up any concerns that you may have about ketamine infusion treatment while discussing the eligibility criteria.
In order to be eligible, you must meet the diagnosis criteria for treatment-resistant depression (TRD) or post-traumatic stress disorder (PTSD). There are a few other criteria that you must meet in order to receive treatment, which will be discussed during the video call.
Once you meet the initial eligibility criteria, you will receive a comprehensive physical exam in order to ensure that ketamine is safe for you. Because it is a dissociative anesthetic, ketamine can slightly affect the cardiovascular and respiratory systems. As such, your providing clinician will want to ensure that you do not have any health conditions that can interfere with your treatment.
Once you have been cleared to begin ketamine treatment, you will be able to choose which day and time work best for you. Since treatment is administered by one of our highly credentialed infusionists at the location of your choice, you may choose to do the treatment from the comfort of your own home.
Phase 2: Treatment
On the day and time of your appointment, one of our highly credentialed infusionists will show up in your location of choice. They will administer the ketamine intravenously for 40 minutes. The entire treatment should be no longer than two hours.
During your entire treatment session, you are free to lay back on a comfortable surface and completely relax. Your clinician will monitor your vital signs, such as your blood pressure, heart rate, and oxygen saturation, in order to make sure that your body responds well to the treatment. However, adverse side effects are incredibly rare.
You should feel the effects of ketamine within minutes of administration. They should peak at about 30 minutes of the treatment. When the infusion is done, you may feel slightly drowsy or dizzy; however, this sensation should subside fairly quickly.
Phase 3: Post-Treatment
Most patients experience profound improvements in their symptoms after a ketamine infusion treatment. However, your providing clinician will still have to follow up with you to ensure that everything went well. They will be able to determine whether you might need additional treatment, maintenance dosing, or a referral to another provider.
Many patients choose to do bi-weekly ketamine infusions over the course of three weeks. Following this course of treatment, you may come back for maintenance sessions at intervals that you and your providing clinician have agreed on.
What Does Ketamine Feel Like During an Infusion?
When you are administered a ketamine infusion, you might feel like you are in an instant state of calm, peacefulness, and relaxation. Most often, this is accompanied by a positive mood state. You may also begin to feel slightly drowsy or sleepy.
At the peak of the treatment, it is possible to experience mild dissociation — one of ketamine’s most notorious effects. Dissociation can be described as an altered state of consciousness in which you feel disconnected from yourself and from the external world.
The experience of dissociation is highly subjective; as such, it is difficult to describe. However, many patients report experiencing a profound shift in consciousness as a result of being in a dissociative state, which may play a role in rapidly alleviating symptoms of treatment-resistant depression (TRD).
Some other sensations described by patients include feeling woozy, “spaced out,” or floating. It is also possible to experience slight impairments, which can manifest as confusion, slurred speech, and difficulty walking.
You may be wondering if ketamine infusions can cause some of the effects that it is known for, such as loss of consciousness, hallucinations, and the infamous “K-hole.” Because ketamine infusions use clinically-appropriate doses, you will not experience any of these extreme side effects.
What Are the Side Effects of a Ketamine Infusion?
Since the 1960s, ketamine has been deemed a safe medication with few adverse side effects for various conditions. In patients being treated for treatment-resistant depression, side effects are likewise very rare. A literature review from the National Institutes of Mental Health (NIMH) found that patients were unlikely to experience anything aside from mild and brief side effects.
The few side effects that were reported include mild dizziness, difficulty speaking, slight visual distortions, and numbness at the injection site. However, none of these side effects persisted for more than four hours following the treatment.
The literature review also looked at side effects several months after treatment. At a three-month follow, they did not find that the patients experienced any cognitive deficits, cravings for ketamine, or propensity for recreational use.
One rare side effect of a ketamine infusion is nausea during or after the treatment. If you experience this side effect, your providing clinician can provide you with anti-nausea medication. However, you can prevent nausea from occurring by not eating a heavy meal before or after your ketamine infusion treatment.
Although ketamine is free of serious side effects, there is something that patients should be aware of. Because ketamine is a dissociative anesthetic, it can slow down the cardiovascular and respiratory systems. This can lead to changes in breathing rate, blood pressure, heart rate, and oxygen saturation.
While this is not a problem for healthy individuals, those with a history of cardiovascular conditions can experience certain side effects. For this reason, it is important to discuss prior health conditions with your providing clinician.
While clinically-administered ketamine comes with very few side effects, the use of street ketamine — which is also known as “vitamin K,” “special K,” or “kit-kat” — can be quite dangerous.
Street ketamine is usually consumed in much higher doses than is safe, which can lead to side effects such as vivid auditory and visual hallucinations, unconsciousness, paranoia, and an extreme state of dissociation known as the “K-hole.”
Since street ketamine usually comes in a white powder form, it can be mixed with other substances such as cocaine or amphetamine. This can significantly increase the risk of overdose.
Over time, users of street ketamine may experience tolerance, addiction, and withdrawal symptoms. Another side effect associated with street ketamine use is called ketamine bladder syndrome, which includes incontinence, abdominal pain, cramps, urinary tract infections, and ulcerative cystitis.
If you are receiving a clinically-administered ketamine infusion, you are very unlikely to experience any adverse side effects. During your actual treatment, you should experience a state of calmness and relaxation, which should be accompanied by a positive mood state.
If you want to discuss what you should expect during a ketamine infusion, you can speak with one of our licensed clinicians. During your free assessment, you can bring up any questions that you may have. Schedule a call with Pasithea Clinics today.
- The Role of Ketamine in Treatment-Resistant Depression: A Systematic Review | NCBI
- Drug Scheduling | DEA
- The role of dissociation in ketamine’s antidepressant effects | Nature Communications
- NIMH » Side Effects Mild, Brief with Single Antidepressant Dose of Intravenous Ketamine | National Institutes of Mental Health