The Long-Term Effects of Using Ketamine for Treatment Depression

Ketamine has emerged as a groundbreaking ketamine treatment for depression, especially for those who have not responded well to traditional antidepressants. Its rapid mental health-acting nature has garnered significant attention, leading to questions about its long-term effects. This blog aims to explore these effects, providing readers with a comprehensive understanding of what to expect from prolonged ketamine therapy.

Understanding Ketamine Therapy

What Is Ketamine?

Originally an anesthetic, ketamine has been repurposed for treating severe depression. It works by targeting NMDA receptors in the brain, which play a role in mood regulation. Ketamine is administered in various forms, including intravenous (IV) infusions, nasal sprays (such as Spravato), and oral doses. Each method offers unique benefits and considerations.

Ketamine induces what doctors refer to as a “dissociative experience,” commonly known as a “trip.” This effect led to its popularity as a club drug, where it goes by names such as K, Special K, Super K, and Vitamin K. Partygoers often inject it, mix it into drinks, snort it, or add it to joints or cigarettes.

Since the 1970s, ketamine has been used as an anesthetic during both human and veterinary medical procedures. Since 1999, ketamine has been classified as a Schedule III controlled substance, making it illegal for non-medical use. On the illicit market, ketamine is commonly encountered as either a clear liquid or a white powder, sometimes pressed into capsule form.

How Does Ketamine Work?

Ketamine is a dissociative drug that distorts sensory perception and imparts a feeling of detachment from oneself and the environment. It has gained popularity as a “club drug” used by teenagers and young adults at raves or parties. A national survey of American youth in 2021 estimated that nearly 1% of all high school seniors had used ketamine in the past year.

Short-Term Adverse Effects of Ketamine

Immediate Effects

Ketamine’s effects may be felt within minutes of use. These can vary in severity based on the amount of the drug consumed. Though the acute effects may last for several hours, some people report effects that persist for several days. At relatively low doses, these effects may include:

• Disorientation, confusion, or loss of motor coordination
• Dizziness, nausea, or vomiting
• Increased blood pressure, heart rate, breathing, or body temperature
• Changes in sensory perceptions, including visual or auditory hallucinations
• Feeling detached from oneself and the surroundings

Higher Doses and Mixed Use

At higher doses, the short-term effects of ketamine treatment for depression may include:

• More intense sensory distortions and dissociation
• Profound respiratory depression, especially when used with other drugs such as alcohol or CNS depressants

Long-Term Effects and Dangers of Ketamine

Substance Use Disorder and Dependence

The long-term use of dissociative drugs like ketamine has not been exhaustively studied. However, ketamine use is thought to be reinforcing, which could be associated with the development of a substance use disorder. Additionally, ketamine use is thought to lead to some degree of tolerance, physical dependence, and withdrawal symptoms when use stops. Ketamine withdrawal syndrome may include symptoms such as depression, excessive sleepiness, and drug cravings.

Neurological Risks

Research indicates that long-term ketamine misuse may have some neurological risks. A 2022 review of research into prolonged recreational ketamine use found that using high volumes of the drug over longer periods was associated with changes in brain structure and function. Though the review urges caution in asserting a causal link, the observed differences could explain some of the long-term adverse effects of ketamine, including memory impairments and declines in executive functioning.

Ketamine Addiction, Treatment, and Outlook

Developing a Dependency

It is possible to develop patterns of compulsive misuse and, ultimately, a substance use disorder with long-term use of dissociative drugs like ketamine. A supervised medical detoxification from ketamine may be helpful for some people in managing ketamine withdrawal syndromes at the start of recovery.

Chronic ketamine use can lead to physical and psychological dependency. Its strong painkilling properties and anesthetic effects make it a highly addictive substance. When a person takes ketamine, they’re likely to experience physical and psychological dissociation, as well as surges in dopamine and serotonin. These feelings can motivate continued use, with the person using the drug to numb their thoughts, feelings, and emotions.

Tolerance and Cravings

A person who regularly uses ketamine may find that they build up a tolerance over time, using higher doses or taking ketamine treatment for depression more frequently to achieve the desired dissociation. With frequent use, the body learns to function with the drug’s presence, leading to physical dependency where the person needs to take the drug to feel stable and ward off withdrawal symptoms. Managing a comedown can be challenging, especially if the person has taken a lot of ketamine, making cravings to take more drugs stronger.

Potential Side Effects

Common Side Effects

Ketamine is not a licensed treatment for depression, and the effects of long-term use are unknown. There may also be unusual side effects which occur acutely that have not yet been reported. About 10% of people who have a ketamine infusion have a challenging experience. However, these side effects usually resolve within 15 minutes of stopping the infusion. Occasionally, people experience a worsening in their depressive symptoms and suicidality, which persists for up to two weeks after taking ketamine.

Brief Side Effects

Common brief side effects during or shortly after ketamine treatment for depression include:

• Feeling dissociated, with a sense of detachment from mind and body
• Ego dissolution, feeling “one with everything” or very tiny
• Dizziness and feeling lightheaded
• Feeling tired for the rest of the day after treatment
• Altered perception, where things look or sound different
• Nausea or vomiting, which can be treated with anti-nausea agents
• Anxiety, sometimes extending to panic, which diminishes rapidly as the drug is broken down in the body
• Headache, usually responding to paracetamol
• Tinnitus, a ringing in the ears, which usually resolves if ketamine is stopped

Less-Common and Rare Side Effects

Vivid Dreams and Hallucinations

Some people experience vivid dreams and hallucinations, feeling, seeing, or hearing things that are not there. Mania, or an unusually elevated mood causing problems, should be reported immediately if suspected.

Rare Physical Side Effects

Rarely, people taking regular ketamine experience liver damage, though this is sufficiently rare that routine checks are not conducted. If you feel unwell during ongoing Ketamine Treatment, a review may be necessary.

Long-Term Theoretical Risks

Dependence and Tolerance

Long-term use may lead to dependence and tolerance, requiring higher doses for the same effect. Patients taking ketamine treatment for depression may find that their condition, initially relieved by ketamine, is no longer controlled despite continuing treatment. This may necessitate a treatment break or stopping the treatment altogether.

Bladder Damage and Cognitive Impairment

Bladder damage is common in those who take illegal ketamine recreationally at high doses. Symptoms include lower abdominal pain, pain during urination, and increased frequency of urination. Cognitive impairment, associated with brain shrinking and other lesions, has been observed in those taking high doses daily.

Personality Changes

Apathy has been reported in addicts but not in patients receiving medical doses. Though ketamine has shown rapid antidepressant effects in clinical trials, the long-term success rates have not been fully documented.

Conclusion

Ketamine has shown promise as a ketamine treatment for depression, especially for those who have not responded to other treatments. While it offers rapid relief for many, the long-term effects and risks, including dependency, tolerance, and potential cognitive and physical impairments, must be carefully considered. As research continues, understanding these long-term effects will be crucial for making informed decisions about ketamine Therapy.