General Overview

Ketamine has been safely used for anesthesia for several years. It is now being used at lower doses to treat psychiatric disorders. It is important to understand that ketamine is not a cure nor is it a quick solution. While symptoms may rapidly improve, they will likely return if ketamine is not used in conjunction with therapy, lifestyle changes and ongoing care.

Ketamine boosts neuroplasticity which helps "rewire" the brain so that it can grow new, healthy connections. This is believed to rapidly improve thought patterns, mood, and overall cognition.

Ketamine injections are given in the deltoid muscle. Patients may receive an initial series of injections, typically 1-2 per week for up to 6-8 shots,  followed by maintenance injections as needed. To decrease the risk of tolerance, dependance and side effects, follow-up injections should be spaced several weeks to months apart. Ketamine injections are an off-label use of ketamine and are not covered by insurance. 

Sublingual ketamine is dissolved under the tongue and produces a milder dissociative effect than other routes of administration. Some patients may see improvement in depressive symptoms with use. Sublingual ketamine is an off-label use of ketamine and is not covered by insurance. 

• Transient disorientation, confusion, or loss of motor coordination.
• Transient dizziness, headache, nausea, or vomiting.
• Transient increased blood pressure, heart rate, breathing, or body temperature.
• Changes in sensory perceptions, including visual or auditory hallucinations.
• Feeling detached from yourself, your surroundings, or your environment.
• Laryngospasm (sudden, involuntary contraction of the muscles of the larynx causing a temporary airway blockage or difficulty breathing). This is a very rare side effect which typically occurs at anesthetic doses that are much higher than those used for treatment of depression.
• Bladder and urinary tract damage resulting in bladder or pelvic pain, urinary frequency, incontinence, haematuria, upper tract obstruction and papillary necrosis. Bladder issues typically occur with high dose, frequent use of ketamine. 
• Long-term use can lead to cognitive changes