What to Know About Ketamine Use


Psychonaught / Wikimedia Commons

Ketamine is a dissociative anesthetic developed in the early 1960s and used in human and veterinary medicine. The drug is primarily used for anesthesia. It has also been used off-label in treating depression and PTSD and has been FDA-approved for treatment-resistant depression.

In the 1950s, phencyclidine (PCP) was developed as an intravenous general anesthetic, but because of its severe side effects, ketamine was designed to replace it. MXE (methoxetamine) is also a similar drug made from arylcyclohexylamines.

This article discusses the possible therapeutic uses of ketamine as well as the potential for addiction. It also covers treatment options that can help people recover from ketamine addiction.

Overview of Ketamine

Ketamine is a Schedule III drug, which means it is approved for use as an anesthetic in hospital and other medical settings. It is safe and effective when used in a controlled medical setting, but it also has the potential for misuse and addiction.

Drug Class: Ketamine is an NMDA receptor antagonist. It has anesthetic, dissociative, and hallucinogenic effects.

Common Side Effects: Ketamine can have side effects, including elevated blood pressure, tremors, hallucinations, confusion, and agitation.

How to Recognize Ketamine

Ketamine usually appears as a clear liquid or a white to off-white powder. It can also be sold illegally in pill or capsule form. It is tasteless and odorless.

What Does Ketamine Do?

In medical settings, ketamine is given intravenously to induce and maintain anesthesia. The drug produces dissociative effects that are short in duration. It can also produce hallucinogenic-like effects, lasting a short period of time, from one to two hours.

It creates a state of total dissociation called a "k-hole." This occurs when large amounts of ketamine are used to the point that it impairs a person's bodily and environmental awareness.

Ketamine's exact mechanisms of action are not fully understood, but researchers believe that it works by affecting glutamate receptors in the brain. Glutamate is a neurotransmitter that has been implicated as a contributor to depression. Because ketamine blocks glutamate receptors, it is sometimes used as a treatment for depression. 


Click Play to Learn More About K-Holes

This video has been medically reviewed by John C. Umhau, MD, MPH, CPE.


Research suggests that ketamine misuse can lead to:

  • Impairments in memory and reduced psychological wellbeing
  • Urinary tract problems
  • Dangerous interactions with other substances such as alcohol
  • Fatal interactions with other sedatives like benzodiazepines, barbiturates, and opiates

Psychiatric Uses

Ketamine has been shown to have antidepressant effects in patients with mood disorders. For this reason, it has been sometimes used intravenously off-label to help treat major depressive disorder and bipolar disorder.

In 2019 the U.S. Food and Drug Administration (FDA) approved an intranasal form of ketamine for use in treatment-resistant depression. Some research has also found that ketamine can reduce symptoms of post-traumatic stress disorder (PTSD).

Studies suggest that ketamine can be fast-acting as an antidepressant, often relieving symptoms in as little as 24 hours. However, using ketamine as a treatment for depression requires a valid prescription and should only be done under the supervision of a medical professional.

It is important to note that research on the mental health uses of ketamine is still in the early stages. There is still much to learn about the safety and long-term effects of the psychiatric use of ketamine.

Common Side Effects

Some of the common short-term side effects that people experience include:

  • Visual disturbances
  • Confusion and disorientation
  • Drowsiness
  • Increased heart rate
  • Elevated blood pressure
  • Nausea and vomiting
  • Euphoria
  • Sedation

Depending on the dosage, some can experience these more severe side effects of ketamine:

  • Severe allergic reaction
  • Hypotension and heart rhythm abnormalities
  • Difficulty talking
  • Abnormal movements
  • Slowed or depressed breathing

How Long Does Ketamine Last?

The anesthetic effects of ketamine usually last between one and three hours. Research suggests that ketamine's antidepressant effects can last two to four weeks.

If you are taking ketamine as a treatment for depression, it is essential to know how long it stays in your system to avoid potential drug interactions. Ketamine has a half-life of approximately three hours, meaning it takes 14 to 18 hours for the drug to be eliminated from a person's system.

Ketamine Addiction and Withdrawal

Ketamine has the potential for misuse and addiction. Some of the signs that someone might be using ketamine include:

  • Changes in sleep habits
  • Irritability
  • Mood changes
  • Hallucinations
  • Difficulty speaking
  • Memory problems
  • Disorientation
  • Presence of drug paraphernalia

The use of ketamine can result in tolerance, dependence, and symptoms of withdrawal. When tolerance occurs, people require larger or more frequent doses of the drug to achieve the same effects they felt initially. Dependence occurs when a person needs to continue taking a drug in order to avoid the negative effects of withdrawal. 


Taking too much ketamine can also lead to a drug overdose. Typically, the outward symptoms of ketamine overdose are the psychotropic effects, including dreams, illusions, and hallucinations—similar to LSD and PCP use.

Benzodiazepines might be given to reduce agitation. This requires caution, however, as in cases of ketamine overdose, ketamine was typically not the only drug ingested. Over-sedation and drug interactions are a concern.

If you believe that someone has overdosed on ketamine or another substance, contact emergency services immediately.


The National Institute on Drug Abuse reported in 2019 that a bit less than 0.1% of people in 12th grade had used ketamine in the past year.

Addiction to ketamine can cause chemical changes in the brain's reward system that make it very difficult to stop taking the drug. Because ketamine creates feelings of detachment, people often experience major disruptions in multiple life areas once they have developed an addiction.

Signs of addiction can include neglecting work and family responsibilities and spending large amounts of money on the drug. The high from ketamine is short-lived and tolerance tends to build quite quickly, meaning people who use it need to increase the amount they use in order to get the same results.

It can also be difficult for those using the drug to gauge how much of the drug they need for their desired effect, which can lead to overdose.


Once people have become tolerant, dependent, or addicted to ketamine, they are likely to experience symptoms of withdrawal when they stop taking it. These symptoms can range in severity from mild to more serious. 

Symptoms of withdrawal can include:

  • Depression
  • Anxiety
  • Rapid heartbeat
  • Fatigue
  • Lack of appetite
  • Insomnia
  • Nightmares
  • Restlessness
  • Tremors
  • Chills or sweats
  • Anger

Because ketamine withdrawal symptoms can sometimes be serious, it can be helpful to go through the detox and withdrawal process under the supervision of trained addictions recovery professionals.

How to Get Help

While ketamine use and addiction is serious, there are effective treatment options available. Treatment options may include cognitive-behavioral therapy (CBT), individual therapy, group therapy, family therapy, motivational enhancement therapy, or other approaches.

Treatment may occur on an inpatient, outpatient, or residential basis.

While there are no specific medications approved for the treatment of addiction to ketamine, interventions may include the use of medications to treat co-occurring psychiatric conditions.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

16 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kurdi MS, Theerth KA, Deva RS. Ketamine: Current applications in anesthesia, pain, and critical care. Anesth Essays Res. 2014;(8)3:283-90. doi:10.4103/0259-1162.143110

  2. Nelson S. Hallucinogens: Unreal Visions. Mason Crest/Simon & Schuster. 2014.

  3. Zanos P, Gould TD. Mechanisms of ketamine action as an antidepressantMol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255

  4. Morgan CJ, Dodds CM, Furby H, et al. Long-term heavy ketamine use is associated with spatial memory impairment and altered hippocampal activation. Front Psychiatry. 2014;(5):149.  doi:10.3389/fpsyt.2014.00149

  5. Ou YL, Liu CY, Cha TL, Wu ST, Tsao CW. Complete reversal of the clinical symptoms and image morphology of ketamine cystitis after intravesical hyaluronic acid instillation: A case report. Medicine (Baltimore). 2018;(97)28:e11500.  doi:10.1097/MD.0000000000011500

  6. Wilkinson ST, Sanacora G. Considerations on the off-label use of ketamine as a treatment for mood disorders. JAMA. 2017;(318)9:793-794.  doi:10.1001/jama.2017.10697

  7. US Food & Drug Administration. FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic. March 2019.

  8. Feder A, Parides MK, Murrough JW, et al. Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry. 2014;(71)6:681-8.  doi:10.1001/jamapsychiatry.2014.62

  9. Corriger A, Pickering G. Ketamine and depression: a narrative reviewDrug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437

  10. LeMone P, Burke K, et al. (Editors). Medical-Surgical Nursing: Critical Thinking for Person-Oriented Care (Third Edition). Pearson Australia. 2016.

  11. Mandal S, Sinha VK, Goyal N. Efficacy of ketamine therapy in the treatment of depressionIndian J Psychiatry. 2019;61(5):480-485. doi:10.4103/psychiatry.IndianJPsychiatry_484_18

  12. US National Library of Medicine. Ketamine.

  13. Zhang MW, Ho RC. Controversies of the Effect of Ketamine on Cognition. Front Psychiatry. 2016;(7):47. doi:10.3389/fpsyt.2016.00047

  14. National Institute on Drug Abuse. Club drugs.

  15. Lin PC, Lane HY, Lin CH. Spontaneous Remission of Ketamine Withdrawal-Related Depression. Clin Neuropharmacol. 2016;(39)1:51-2. doi:10.1097/WNF.0000000000000121

  16. Lerner A, Klein M. Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development. Brain Communications. 2019;(1)1.  doi:10.1093/braincomms/fcz025

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.