Ketamine

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Ketamine is a dissociative medicine which has similar long term effects as psychedelics. Ketamine is renowned for inducing a ‘dissociated state’ which is when the brain to become transiently disconnected from the environment while maintaining vivid, internally generated experiences. Ketamine has recently garnered prominence as a fast-acting therapeutic agent used in the treatment of depression[1].

Effects

Ketamine has been shown to cause:

These effects are thought to occur due to flipping of a “switch” in the brains which shuts off neurons that had been firing in the awake state while activating a separate group of previously dormant neurons.

History of Use

Ketamine has been used as a general anaesthetic for more than 60 years. Phencyclidine, also known as PCP, was produced in the 1950s by researchers looking to improve anaesthetic medications. Despite the fact that PCP did a good job of keeping most patients unconscious throughout surgery, some did experience what the authors of a 1959 experiment called "delirium and hallucinations which, although normally of a highly gratifying nature, are sometimes rather alarming to the patients." This so-called dissociative state, in which the brain experiences things that are not grounded in reality, can continue up to 12 hours.

In order to create a substance with a shorter duration of action, scientists created ketamine, a substance that shares structural similarities with PCP. According to Joe Cichon, a neuroscientist and anesthesiologist at the Perelman School of Medicine at the University of Pennsylvania, ketamine is still a widely used anaesthetic today. People stay conscious while taking lesser doses than would be required for anaesthesia, but for a much shorter period of time and in a similar dissociated state to PCP. Researchers discovered in the 2000s that these lower, so-called subhypnotic ketamine doses have an antidepressant effect that can endure for several weeks, well after the body has metabolised the drug, according to Cichon. We still don't fully understand how it exerts all these varied effects 60 years after it became available for human usage.

Abuse

Like any drug, overuse is linked to negative effects. It has been found that chronic, uncontrolled use may lead to ketamine-induced ulcerative cystitis and neurocognitive impairment which can impact negatively upon achievement in education and at work, and also compound addiction problems.[2]

References

  1. Zhang K, Hashimoto K. An update on ketamine and its two enantiomers as rapid-acting antidepressants. Expert Rev Neurother. 2019 Jan;19(1):83-92. doi: 10.1080/14737175.2019.1554434. Epub 2018 Dec 4. PMID: 30513009.
  2. Morgan CJ, Curran HV; Independent Scientific Committee on Drugs. Ketamine use: a review. Addiction. 2012 Jan;107(1):27-38. doi: 10.1111/j.1360-0443.2011.03576.x. Epub 2011 Jul 22. PMID: 21777321.

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