Can Ketamine kill me or hurt me?
It's not likely that ketamine can kill or seriously hurt the well-prepared, informed user doing a journey with a licensed practitioner. So you can rest easy! "Ketamine’s wide therapeutic range makes it one of the safest anesthetics available" (Li and Vislides, 2016).
Here's the absolute contraindications for ketamine (conditions under which ketamine should not be administered):
CONTRAINDICATIONS:
- Known hypersensitivity or allergy to ketamine
- Cardiovascular disease such as uncontrolled hypertension or arrhythmia
- Active bleeding or coagulopathy
- Pregnancy or breastfeeding
- Chronic kidney disease
- History of ketamine abuse
- Schizophrenia, or borderline personality disorder
- Hyperthyroidism
There is some wiggle room on the above list. For example, if you have hypertension but it's well controlled on medications, etc. So determinations should be made on a case-by-case basis.
Here's a list of the psychiatric precautions with Ketamine:
- History of Psychosis
- Personality Disorders
- Severe PTSD
- Active Substance Abuse
- Past Substance Abuse
- Acute Suicidal Ideation
Beyond that, there are some other risks with Ketamine. Here's a review of all the known issues with Ketamine use/abuse:
RISKS/ADVERSE EVENTS:
- Ketamine may increase salivary secretions (Corssen and Domino, 1966) and potentially increase the risk of laryngospasm, but this is rarely reported (Green et al., 2010).
- Because ketamine increases cerebral metabolism, it can potentially increase intracranial pressure (ICP) and has been used cautiously in patients with space-occupying cerebral lesions brain injury (In fact, in some cases, ketamine’s cerebral effects may be neuroprotective and potentially beneficial for brain trauma patients )
- Ketamine has multiple dose-dependent side effects, though most of which are self-resolving. Adverse effects include hypersalivation, hyperreflexia and transient clonus (Corssen and Domino, 1966).
- Ketamine may also cause vestibular-type symptoms including dizziness, nausea and vomiting.
- Cardiopulmonary toxicity is rare, with effects limited to those caused by the transient sympathetic activation such as tachycardia, hypertension and palpitations (Weiner et al., 2000; Strayer and Nelson, 2008).
- Given ketamine’s wide therapeutic range, death by overdose is rare and usually involves other intoxicants or in the setting of trauma (Moore et al., 1997; Gill and Stajic, 2000)
- More recently, cystitis and various lower urinary tract pathologies (e.g., detrusor over-activity) have also been reported in long-term ketamine users (Chu et al., 2008; Tsai et al., 2009).
- Ketamine abuse is also associated with gastrointestinal symptoms, including biliary dysfunction, epigastric pain and hepatic injury (Poon et al., 2010; Lo et al., 2011; Wong et al., 2014; Yu et al., 2014), though these adverse effects may be reversible with abstinence (Zhou J. et al., 2013; Wong et al., 2014; Yu et al., 2014).
- Finally, given its CNS modulatory activity, ketamine should be used cautiously with other drugs that alter mood and perception, including alcohol, opioids, benzodiazepines and cannabis. Ketamine metabolism involves cytochrome P450 enzymes (Hijazi and Boulieu, 2002), and thus, concomitant use with drugs that inhibit cytochrome P450 metabolism may lead to inhibited ketamine metabolism and supratherapeutic toxicity.
Before undertaking a Ketamine session we will go over your current medications, your allergies and your substance use history to make sure that this is a reasonable choice for you!
5 Lessons
Curious about Ketamine: An overview
Ketamine is a synthetic drug discovered in the 1960s. Initially used as an anesthetic, Ketamine has become popular for a whole host of reasons.
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*Please take note: This module is for general educational purposes only. Jennifer Boyd is a Physician Associate licensed in the states of CT and NY. You are required to have your own licensed medical provider to help you manage your health.