K-Hole and the Effects of Ketamine

A "k-hole" is how it feels when you take a high enough dose of ketamine that both your environmental awareness and bodily control become very impaired. When someone has "fallen into a k-hole" (the slang term for this ketamine effect), they are temporarily unable to interact with others or the world around them.

Ketamine is a dissociative drug, which means that it can make users feel detached from reality and themselves. It was originally used as an anesthetic, but has also been found effective for treating major depression and bipolar disorder—under medical supervsion.

Learn what a k-hole is and the symptoms people experience in this state. This article also discusses other ketamine effects, how it can be used to treat certain mental health conditions, signs of a ketamine overdose, and how to get help.

Effects of a ketamine high
Verywell / JR Bee

What Is a K-Hole?

A k-hole is when high doses of ketamine lead to intense feelings of dissociation. This can cause feelings of being disconnected from or unable to control one's own body, also sometimes affecting the ability to speak and move around easily.

One way to think about a k-hole is as a state between intoxication and coma. Some people refer to a k-hole as an out-of-body or near-death experience.

As the consciousness of the real world diminishes, alterations in the senses during a k-hole may lead to illusions and hallucinations. While usually temporary, some people have shown ongoing dissociative and psychotic symptoms with long-term ketamine misuse.


Click Play to Learn More About K-Holes

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

K-Hole Symptoms

A k-hole can be frightening and induce strong feelings of powerlessness. This may be especially intense if your ability to speak is affected. When in a k-hole, it can be frustrating if someone is trying to communicate with you and you can't respond.

To others, someone in a k-hole may simply look immobile and intoxicated, although their eyes may move around. This is an effect known as nystagmus. Other k-hole symptoms include marked confusion, unexplainable experiences, floating sensations, and mind/body dissociation.

Ketamine Effects

One of the risks of falling into a k-hole is difficulty coming out of the dissociative state. Some people continue to feel disconnected from the world around them (and from their life), and may even develop ongoing symptoms of psychosis.

Ketamine can have effects on the brain, heart, and more. Short-term side effects of taking ketamine can include:

  • Dilated pupils
  • Elevated blood pressure
  • Increased heart rate
  • Increased salivation and tear secretions
  • Involuntary rapid eye movement
  • Muscle stiffening
  • Nausea

Long-term side effects of taking ketamine frequently and/or at high doses include:

  • Bladder problems
  • Cardiac issues
  • Cognitive effects
  • Seizures

Why People Take Ketamine

While researchers are still learning more about how ketamine works, some of its effects are believed to stem from blocking glutamate receptors in the brain. Glutamate is one of the most abundant neurotransmitters found in the body that helps regulate important parts of the nervous system. 

Overstimulation of the glutamate pathways in the brain may contribute to the onset of depression. Because of this, ketamine has attracted attention as a possible treatment for the condition.

However, it is important to note that ketamine is a controlled substance categorized as a Schedule III drug. It is legal when prescribed by a licensed medical professional. Ketamine is illegal when used recreationally.

Like other substances, some people use ketamine as a way to cope with distress or as a way to self-treat feelings of depression. However, it is important to only use ketamine under the direction and supervision of the doctor. Your doctor can evaluate your symptoms and recommend treatments that will work best for your needs.

Ketamine and Depression

A review of several studies found that ketamine is a fast-acting antidepressant, often reaching maximum efficacy at 24 hours. This can appeal to people with depressive symptoms, especially when many antidepressants take weeks to months before any changes are noticed.

Research has shown that people who use ketamine more heavily tend to be more depressed than occasional users. It's not clear whether the depression is caused by ketamine use and its impacts on people's lives, or if people who are already depressed are more vulnerable to ketamine misuse as a form of self-medication.

Treating depression with ketamine should only be done under the supervision of a trained healthcare professional and with a valid prescription. If you have been trying to escape negative feelings through taking drugs like ketamine, consider talking to your healthcare provider about other ways of treating depression.

Ketamine Addiction

People tend to develop a tolerance to ketamine quickly, which means it requires more of the substance to produce the same effects. Ketamine can be safe when used as prescribed in clinical settings, but misuse may lead to psychological dependence. 

Symptoms of ketamine addiction can include:

  • Changes in appetite
  • Chronic bladder problems
  • Drug cravings
  • Fatigue
  • Feelings of anxiety
  • Hallucinations
  • Low mood
  • Nightmares
  • Problems with concentration and memory

People who have a psychological dependence or addiction to ketamine may also find it difficult to function normally in their daily life. It can interfere with important daily tasks including school, work, social relationships, and family life.

Signs of Ketamine Overdose

Taking too much ketamine can cause an overdose. Signs of a ketamine overdose include dangerously slow breathing and loss of consciousness.

Other symptoms of a ketamine overdose can include:

  • Anxiety
  • Chest pain
  • Elevated blood pressure
  • Hallucinations
  • Loss of consciousness
  • Nausea or vomiting
  • Paralysis
  • Rapid or irregular heart rate
  • Seizures

If an overdose is suspected, get immediate medical attention.

How to Get Help

There are many effective and much safer ways of treating depression than seeking out a k-hole. If you have been through significant trauma, such as physical, sexual, or emotional abuse, or if you are struggling with feelings of guilt or emptiness, there are various therapies that can help you.

A mental health professional can help find the best treatment options for you. This might include psychotherapy, medications, or both. These treatments can help you feel better without having to experience a k-hole or other negative ketamine effects.

If you are experiencing symptoms of ketamine addiction, talk to your doctor about your treatment options. Treatment options often involve therapy and support groups. Types of therapy that may be helpful include cognitive behavioral therapy, group therapy, or motivational enhancement therapy.

There are no FDA-approved medications to treat ketamine addiction. However, your doctor may prescribe medications to treat symptoms of other conditions you are also experiencing, such as anxiety, depression, or bipolar disorder. 

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.

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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.
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By Elizabeth Hartney, BSc, MSc, MA, PhD
Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada.