What To Expect After Taking Oral Ketamine?
Ketamine has a long history in medicine where it is used as a dissociative anesthetic, sedative, and painkiller and is often employed in the emergency department for such procedures as resetting a broken arm or repairing lacerations.
More recently, ketamine has gained notoriety for its ability to quickly help a variety of mental health conditions such as anxiety, depression, and post-traumatic stress disorder. Unlike other antidepressant medications, ketamine acts quickly and may have a significant impact even after a single dose.
It is also showing promise to work in tandem with antidepressants in patients with treatment-resistant depression who wouldn’t otherwise benefit from traditional antidepressants and therapy. Another reason that it is highly considered is the quick action, meaning that you get the effects much faster than traditional antidepressants.
That is why so many psychiatrists and psychologists are excited about the possibilities of this one-of-a-kind medication.
Once you have connected with your doctor at ISHA via telehealth, they will instruct you to consume the ketamine lozenge. It’s important to remember that the entire session may take up to three hours for your body to full process the ketamine, finish experiencing the symptoms, and talk through any concerns with your therapist.
Your doctor will instruct you about your other medications and whether it is safe for you to take them as normal or whether you should skip them for the day of your session. Ensure that you have a comfortable place to lie down during the session. Some people prefer to dim the lights and turn on a soothing music for further comfort.
Many doctors recommend fasting for minimum of four hours prior to your first ketamine session since a common side effect is nausea and vomiting. As your body adjusts, you may be able to reduce your fasting period to three hours before subsequent sessions. Your doctor will ask you not to drive for the rest of the day for your own safety, even after you have recovered from your session.
User Experience Regarding Oral Ketamine
Oral ketamine is less potent than intravenous forms and takes between 20 minutes to an hour to take effect. Once it does take effect, you may feel calm, detached, or dreamy with the sensations lasting about 30 minutes to an hour. Throughout the hour, patients typically feel a visible improvement in their mood and many will reach a state where they encounter stored emotions or experience enhanced perception.
This first stage is often accompanied by feelings of warmth and comfort. Some people may experience a mild, calming euphoria and feeling at peace with the universe. However, you are still completely aware of your body and shouldn’t see any hallucinations.
However, there are multiple stages of ketamine-induced non-ordinary states of consciousness. The majority of patients will only reach the first one we described above with our dosage, but patients who are more sensitive to ketamine may reach deeper stages with oral ketamine.
By providing patients with lower doses of ketamine, doctors hope to reap the benefits of the medication and avoid most, if not all, of the psychedelic effects seen at higher doses. This is the main difference between users seeking a high and patients working towards a goal with their mental health issues.
At the second stage, you would encounter what is known colloquially as an out of body experience. This might involve feeling completely detached from your body, visual or auditory hallucinations, vivid dreams or recollections of previous dreams, a dreamlike state, or seeing geometric, nonexistent patterns on existing objects.
Even higher doses can lead to the third stage where users feel the ability to leave their body behind entirely and transcend the material plane with their souls. Some people see their lives ‘flash before their eyes’ or relive important moments with the same detachedness that allows them to judge their previous actions.
The fourth stage leads to ecstasy that many describe as dying and being reborn, or becoming one with the universe. Many people find that their attachment to their bodies disappears entirely, as does their sense of self.
At the deepest stage, ketamine acts as a sedative. That is the typical dosage used in hospitals during surgical procedures. Patients at that stage are entirely unaware of what is happening and their bodies are totally relaxed. The dose for ketamine psychotherapy should never reach this stage, no matter how sensitive you are to the medication.
Though reaching the stages past the first are rare with oral ketamine at regulated, subdissociative doses is very rare, it can happen. It is best to be prepared for any kind of reaction to a new medication. ISHA walks you through the process with our telehealth medical professionals who monitor you continuously throughout the experience.
Regardless of which stage you enter, it is not unusual to feel fatigued for the rest of the day after a session. Patients may also feel ‘foggy’ or have trouble making complex decisions. It is not often recommended to return to work directly after a ketamine psychotherapy session.
Long and Short Term Benefits
After the session, patients report fewer suicidal thoughts, increased ability to focus, better sleep and increased activity, socialization, and motivation. For patients with chronic pain, a single dose of ketamine may be enough to curb acute exacerbations. Current research indicates that a single session may be enough to mitigate acute suicidality, but that it rarely provides any long-term benefits.
Most patients report noticing the improvements within 24 to 48 hours after their first session. This is a significantly shorter improvement time than traditional antidepressant medications which often take weeks to show any effects. This short-term improvement typically lasts a few weeks.
Patients on maintenance ketamine have reported a significant and transforming effect on their symptoms with longer periods of normal functioning and fewer episodes of severe depression. Maintenance ketamine is typically synonymous with six ketamine psychotherapeutic sessions over a period of a few weeks.
For some people, the initial six sessions are all that are needed for positive, ongoing responses to depression, anxiety, and PTSD. For others, the improvements last for a while before fading and the patients need additional sessions to keep up their progress toward mental health.
Ketamine Assisted Psychotherapy At ISHA
At ISHA, we have licensed psychologists and psychotherapists who work alongside physicians to monitor and supervise patients throughout ketamine treatment. You will be given oral ketamine lozenges to treat your mental health issues at home. Your therapist will prepare you for this section of the work and will assure your safety at home. You will be given full assistance during this time.
Additionally, you may want to prepare your space appropriately. If you have children at home, you should arrange for a caretaker to be home who will keep your kids out of the room you designate for your ketamine session.
Griffiths, C., Walker, K., Reid, I., da Silva, K. M., & O'Neill-Kerr, A. (2021). A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’project. Journal of Affective Disorders Reports, 4, 100079