Ketamine

The need-to-know information about Ketamine (Ketalar)

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Pearls and Fun Nuggets

1. Ketamine is very versatile 🔧 It functions as both an analgesic (in small doses) AND a sedative (in large doses), making it particularly useful in emergency medicine.

2. It can help treat depression 😭    Ketamine has been found to be a rapid-acting antidepressant.[14][50][51][52][53] It also may be effective in decreasing suicidal ideation, although based on lower quality evidence. The antidepressant effects of ketamine were first shown in small studies in 2000 and 2006. They have since been demonstrated and characterized in subsequent studies. A single low, sub-anesthetic dose of ketamine given via intravenous infusion may produce antidepressant effects within four hours in people with depression.

3. Beware the “K-hole” 😵  At subanesthetic doses—under-dosaged from a medical point of view—ketamine produces a dissociative state, characterised by a sense of detachment from one’s physical body and the external world which is known as depersonalization and derealization. At sufficiently high doses, users may experience what is called the “K-hole”, a state of dissociation with visual and auditory hallucinations.

4. Watch your drinks🍷 Because of its ability to cause confusion and amnesia, ketamine has been used for date rape.

5. Recreational ketamine has some hilarious street names 😆 To name a few…..”Special K”, “K”, “Kitty”, “Kallie Ziltz”, “Kartáč”, “Ket”, “K2”, “Vitamin K”, “Super K”, “Honey oil”, “Jet”, “Super acid”, “Mauve”, “Special LA coke”,“Purple”, “Cat Valium”, “Knod-off”, “Skittles”, “Blind Squid”, “Keller”, “Kelly’s Day”, “New ecstasy”, “Psychedelic heroin”, “bump”, “Majestic”. A mixture of ketamine with cocaine is called “Calvin Klein” or “CK1”. In Hong Kong, where illicit use of the drug is popular, ketamine is colloquially referred to as “kai-jai”.

 

Patient Perspectives

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“I was in for a gallbladder removal, not an emergency. The Anesthesia team decided to do an awake intubation because I have a difficult airway. They said they were giving me something to help me relax. What happened next was the farthest thing from relaxing I can imagine. One dose of Ketamine and I was hallucinating, dissociated, delirious, paralyzed, and the one trace of lucidity that I retained told me that I was end of life because I couldn’t breathe. I had no sense of time passing, so I have no idea how long this lasted. It was the most terrifyingly awful experience I have ever had, and I’m still an emotional mess two weeks later. Never again! Why would anybody ever dose a non-emergency patient with this stuff without extensive consultation about the effects beforehand? If I could give this drug a negative score, I would.”

 

 “I have used this for depression and chronic pain. I’ve had the IV and the dose was small. Anyway, the relief from the pain is fairly immediate and it’s such a relief to have no pain for 45 minutes. Amazing! For the depression, it’s really interesting. It doesn’t seem to take it away but it makes me feel better enough that my life is better and I feel generally cheerful and content and I don’t have to fake it like I normally do. That’s also a huge relief. I’ve not had any bad side effects so far. That’s probably because it’s very carefully supervised. I highly recommend trying it.”

 

References

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