Formerly used as an anesthetic, ketamine is a dissociative drug that can induce a feeling of being detached from reality and your own body. Today it is commonly used to treat anxiety, bipolar disorder, PTSD, and depression¹.
Every person will have different experiences with ketamine; in low doses, ketamine infusions can act as a painkiller and a sedative, creating a relaxing environment for patients. In higher doses, ketamine experiences may include hallucinatory side effects².
Hallucinations as a side effect of ketamine can sound intimidating but are typically uncommon as most patients don’t receive a high enough dosage. Low doses produce positive results with most ketamine patients, but if you need a higher dosage, there is no cause for concern².
Ketamine is a safe drug for treating physical ailments and mental health, but being informed of the types of side effects that you may experience can be helpful to ease concerns about the treatment.
Ketamine as a Psychedelic
In some circumstances, having a psychedelic experience with ketamine may be the goal for both the patient and the medical provider. These hallucinations are sometimes referred to informally as ‘K-land.’
Ketamine’s effects typically provide pain relief, antidepressant effects, and feelings of euphoria, while some patients report having a spiritual experience². When using ketamine in high doses as a psychedelic, your body and mind may become impaired. You may experience a loss of environmental awareness and be temporarily unable to interact with the outside world¹.
Ketamine’s psychedelic effects in high doses may also cause intense visuals and an out-of-body experience. You may feel like you are watching yourself outside of your body, or like you are watching the world or the visuals you see inside a movie theatre. With a high dose, the real world may slip away as you lose connectivity with your environment¹.
Some other common hallucinations you may experience are spinning shapes and fractals with open or closed eyes, and you may experience the sensation of floating, or that time no longer exists¹. During the session, you may also be unable to talk or move your body, or experience nausea, confusion, and dizziness².
Ketamine’s psychedelic effects, at higher doses, are sometimes described as a near-death experience or a state between intoxication and a coma¹. For some patients, these sensations may be more uncomfortable than pleasant, but this depends on the individual’s experience and preferences as many still find the experience enjoyable.
Compared to other types of psychedelic drugs and therapy, ketamine’s side effects do not last long. Ketamine’s psychedelic effects usually last only as long as the infusion is continuing, and may continue for a few minutes afterward, whereas other hallucinogenic drugs like LSD and psilocybin can last for up to 6 to 8 hours².
Scientific Explanations Behind Ketamine’s Psychedelic Effects
When administered ketamine, you disrupt the activating system of the brain – the glutamate system – which can be seen as the ‘on’ switch throughout your brain. Taking too much ketamine can cause your neurological system to be too weak, and potentially, lose consciousness³.
Suppose you are given ketamine in an operating room setting as a sedative anesthetic. In that case, it can put you and your body into a state of extreme synchronicity as your brain can get locked into a repetitive and rhythmic pattern³. This limits what you can and cannot do because all the brain activity is working to help you fall asleep³. At these sedative doses, the activity in your brain becomes disorganized once you are on ketamine. If you’re in a deep sleep, you are over-synchronized.
If you’re in a psychedelic state, however, your body and brain are under-synchronized and you are seeing and experiencing things differently from what they are. Normal consciousness is a level of activity somewhere between the two³.
Psychedelic Experiences with Ketamine
Outside of a licensed medical setting, psychedelic experiences with ketamine may vary and can be on the extreme side of the spectrum³. Recreational users have explained that they experience visual effects of blurriness, strange colors, and even visions or hallucinations³.
Some ketamine users have also reported returning to their previous psychedelic experience, and can even experience an entire reality separate from the real world with their imagination. One such user explains that they had an experience with ketamine where they would return to the same state in a sense where they had a family³.
This experience is not out of the ordinary, as the brain likes to attempt to fill in the gaps of the unknown. Everything you do, see, think, and feel has been learned due to neurotransmitters, with glutamate playing a large role. When on ketamine, glutamate is dispersed to other areas of the brain, and those processes become distorted³. In a ketamine-induced state, standard sensory inputs from the eyes or ears are disrupted, so your brain is trying to fill in any missing gaps. Using past experiences as an anchor, your brain is able to work out a clear and regimented way to make sense of a ketamine experience³.
Benefitting from Ketamine’s Psychedelic Effects
One of the benefits patients report after a ketamine therapy session is the feeling of calmness, and the ability to look at their life and the world from a more objective point of view. Ketamine in high doses or experiencing psychedelic effects may increase these benefits, removing feelings of doubt or fear and allowing you to better examine your mental state or even traumas without such an intense emotional attachment².
Preparing for the Psychedelic Effects of Ketamine
First and foremost, before you go through the procedure, your ketamine provider will explain what will happen and what to expect so that you are fully prepared for any side effects you may experience during your session².
Before your session, the best way to prepare for experiencing ketamine at a low or high dose is to get comfortable physically and mentally. Wearing comfortable clothing and listening to music can be a great way to remain physically comfortable during your ketamine infusions. If possible, it can also be ideal to come to your sessions in a relaxed mood, especially if you are not familiar with ketamine therapy yet, though this is not necessary². Setting an intention that you can come back to as an anchor is extremely helpful, both during the session and in helping to integrate the experience.
Although a lot of patients enjoy the effects of ketamine, it is not always comfortable for everyone. If you find yourself uncomfortable or overwhelmed during a session, try to remind yourself that what you are experiencing is normal and that the effects are not permanent². In fact, the effects of ketamine are very short-acting due to the nature of the IV medication. It is really 24 hours later that we see an impact in the brain with new neurons growing, tapping into your own brain’s neuroplasticity.
Role of Integrating the Ketamine Experience
It is really important to debrief about these new thoughts and observations with a trained therapist. At Avesta Ketamine and Wellness, mental health nurse practitioners can help with this process directly after the infusion while the memories are fresh.
Avesta Ketamine and Wellness
Avesta Ketamine and Wellness, values your mental health and we are committed to improving your well-being. If you have any questions about ketamine therapy and its potential to experience psychedelic side effects, please schedule your consultation or give us a call.
¹ Hartney, E. (2022, June 20). Taking ketamine can mean experiencing a K-hole. Verywell Mind. Retrieved January 18, 2023, from https://www.verywellmind.com/what-is-a-k-hole-21861
² Ketamine News. (2019, July 24). A K-hole, what is it and how can you achieve it safely. Retrieved January 18, 2023, from https://ketamine.news/a-k-hole-what-is-it-and-how-can-you-achieve-it-safely/
³ Buchanan, R. (2020, February 26). Ketamine: What is a K-hole and what does it feel like? Ketamine: What Is a K-Hole and What Does It Feel Like? Retrieved January 18, 2023, from https://www.vice.com/en/article/939nm5/k-holing-why-ketamine-causes-wild-hallucinations
Department of Justice/Drug Enforcement Administration. (2020, April). Drug Fact Sheet: Ketamine. Retrieved January 22, 2023, from https://www.dea.gov/sites/default/files/2020-06/Ketamine-2020_1.pdf
Photo by Merlin Lightpainting: https://www.pexels.com/photo/woman-with-blue-and-white-hair-11137996/
Author Dr. Ladan Eshkevari, PhD, CRNA, FAAN Dr. Eshkevari is the lead clinician at Avesta, and is a long time researcher and educator in physiology, biophysics, and anesthesiology. She is passionate about assisting patients with retractable, difficult to treat mood disorders, and relies on the latest research to bring evidence to Avesta’s practice to better understand and serve patients.