Ketamine has traditionally been used as an anesthetic for medical procedures, first in veterinary clinics and then in people after the FDA approved it for human use in 1970. Shortly after that, it began taking off among hippies and then in 80s and 90s nightclubs, according to Steven Levine, a New Jersey–based psychiatrist and founder of Actify Neurotherapies, a treatment center with locations in several cities. Still, it’s more popular as a recreational drug in the UK and southeast Asia than it is in the U.S.
Over the past decade or so, legal ketamine clinics have popped up to treat depression, OCD, and other mental health conditions. It sometimes has transformative effects for people who haven’t responded to conventional psychiatric medications, said Prakash Masand, a psychiatrist and founder of the Centers of Psychiatric Excellence, which specializes in Ketamine IV therapy for psychiatric conditions that haven’t been alleviated by other methods. “It has literally saved lives for people who were ready to give up all hope,” Masand said.
Because experiences with ketamine vary so drastically, it’s hard to know what you’ll feel on it. That said, here’s what you should know if you’re thinking of trying it.
What does it feel like to take ketamine?
Aside from being a sedative, Ketamine has dissociative properties, which means it can make you feel disconnected from your body and the world. “This may be accompanied by vivid dream-like feelings and out-of-body experiences,” Masand said.
At low doses, this can be a pleasant experience, making someone feel “at one with the universe,” said James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center. Or, it might give them a more objective perspective on their lives, as it did with me.
This is why ketamine can be helpful for PTSD patients, Levine said—they can work through their trauma without reliving all the emotions associated with it. Those with depression may find it helps them feel “less isolated and less alone,” he said.
But at higher doses, people can experience derealization, or detachment from reality, which can lead you to make dangerous decisions. Some people fall into the aforementioned K-holes, where they’re temporarily immobile. “It is termed a ‘K-hole’ because a person is typically unable to process any external information and may appear to be immobile and not responding to verbal stimuli,” Masand said. “It may be accompanied by hallucinations and psychosis. There have been reports of individuals taking hours to come out of a K-hole.”
Other not entirely pleasant effects of ketamine can include anxiety, dizziness, or loss of balance. Patients often don’t enjoy the experience, and make comments like “time is going slowly” or “I feel a bit sunken in my chair,” Masand said.
Ketamine might also affect sensory perception. For some people, colors get brighter and more intense, Levine said. At higher doses, many have full-on hallucinations. Others find that their hearing becomes more acute, which could explain why my friend’s dog freaked me out so much. “When we use it clinically, if somebody is in a room and there are whispered voices in another room or the other side of the building, you can clearly hear them,” Levine explained.
How long does a ketamine trip last?
Ketamine’s effects typically last for just about an hour, but they can continue for as long as a day, depending on the dose and method of ingestion, Masand said. Some people just sleep off lower doses of ketamine, but others may continue experiencing a sense of derealization the day after taking it, especially at high doses. Ketamine hangovers can also include “dizziness, incoordination, [and] impaired attention and memory,” according to Masand.
How do people use ketamine?
Recreationally, ketamine is usually snorted in powder form and occasionally taken as a pill, while in clinical settings, it’s often administered via IV or injections. Some clinics have therapists in the room supervising and talking to patients, while others leave you to yourself, often providing blindfolds or noise-blocking headphones to help you focus.
The main difference between different methods of ketamine administration is in the timing of the trip, said David Manjoubi, anesthesiologist and founder of Ketamine Healing Clinic of Los Angeles. Shots will come on more quickly and end more quickly than IVs, snorting will take longer than both, and oral administration takes the slowest to set in.
Another, newer way of taking ketamine is through a nasal spray that can be prescribed to use at home as a treatment for depression or other mental health issues. This spray is made of a type of ketamine called esketamine, which is different in molecular structure, but has the same effects as the ketamine you typically hear about. As Mahjoubi explained, “Esketamine is just another form of ketamine.”
Unsurprisingly, people have appropriated esketamine spray as a party drug, with some ravers preferring the smaller, more controllable doses. “Some people call it a princess high,” said Giordano. “It’s light and wafty, not necessarily as profound, and the incidence of experiencing the K-hole phenomenon is less.”
In another new model of ketamine therapy that’s gained popularity in the age of social distancing, some clinics will prescribe ketamine tablets for patients to take at home while they video chat with a clinician.
