Ketamine and its Effects on Sensory Perception

Bailey L. Julian

Seton Hill University

SPA 220 02

September 21, 2020

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Ketamine is a dissociative drug most frequently used for starting or maintaining

anesthesia. A dissociative drug distorts perceptions of the patient's vision and hearing. Also, it
makes the person feel detached from their environment. It is used to reduce pain and overall
feeling. Ketamine places the patient in a state where they cannot feel any pain or other
sensations, and they will not remember anything. First used as an anesthetic in the early 1960s,
small doses of ketamine were used as pain relief during the Vietnam War, and is now being
used as a form of antidepressant. Ketamine can be taken through an IV, orally, and through a
sedation mask. Veterinary practices also use ketamine to sedate the animal for a minor, brief,
surgical procedure that does not require skeletal muscle relaxation. Ketamine is known to block
the n-methyl-d-aspartate (NMDA) receptor to elicit its effects.
As an anesthetic, ketamine puts the patient in a state of dissociative anesthesia, which
includes hypnosis, intense analgesia, and increased sympathetic activity. 1 The NMDA receptor is
an excitatory glutamate receptor and ion channel protein found in nerve cells. The blockade of
the excitatory synaptic activity causes the loss of responsiveness and puts the patient in an
anesthetic state. Ketamine is an open channel blocker, meaning it binds to the cell and prevents
the normal function of agonist binding. At concentrations within the clinical dose range,
ketamine is known to affect many more cellular processes, such as neuronal hyperpolarization
and nicotinic acetylcholine ion channels.1 When taking ketamine orally, effects will start around
5-30 minutes, while snorting will take 5-15 minutes. Loss of responsiveness to the outside world
occurs at about twenty times higher concentrations of ketamine compared to other drugs, and
since ketamine has a half-life of about 3 hours, the is a prolonged period after anesthesia in
which the drug levels are lying in the concentration range that produces psychotomimesis.
Psychotomimesis is the onset of psychotic symptoms following the administration of such a
drug. The patient's judgement, senses, and coordination may be impaired for around 24 hours
after the dose of ketamine.
Ketamine has also been used as “date rape” and “club” drugs. Date rape drugs are used
to facilitate sexual assaults in the context of dating. Usually used as a powder or liquid,
ketamine will lower the victim's self-awareness and perception of the world around them,
causing them to be easily manipulated. As a club drug, Ketamine is often used by teens and
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young adults at dance parties. It is most commonly abused by those 16 to 25 years of age.
Ketamine is either injected, snorted, or added to tobacco or marijuana cigarettes and smoked.
When misused, ketamine may cause ulcers and pain in the bladder, kidney problems, and
stomach pain. Also, there is a risk of contracting HIV due to sharing of needles when injecting
ketamine at parties. Ketamine is used as a date rape and a club for its hallucinogenic affects and
the feeling of dissociation from the real world.
Recently, ketamine has had a large spike in usage to treat resistant major depression.
Major depressive disorder is among the most common disorders worldwide, with nearly three
million cases per year. Symptoms of major depression vary from person to person, some
common symptoms are anxiety, hopelessness, mood swings, trouble sleeping or restlessness,
excessive or loss of appetite, lack of concentration, or thoughts of suicide. In a 2010 study,
Baylor College of Medicine and Icahn School of Medicine at Mount Sinai enrolled patients
between the ages of twenty-one and eighty, had a primary diagnosis of major depressive
disorder, and had an inadequate response to at least three therapeutic trials of an
antidepressant.2 In this study, they randomly assigned the participants in a 2:1 ratio to receive
an intravenous infusion of either ketamine or midazolam for over 40. Patients were discharged
from the research unit 24 hours after the infusion and received outpatient evaluations 48
hours, 72 hours, and 7 days post infusion. After 24 hours, the patient had a significant decrease
in their scores on the Montgomery-Åsberg Depression Rating Scale.2 After the study, patients in
the ketamine group had significantly greater improvement in the MADRS score at hours than
the midazolam group. Their mean MADRS score was lower than in the midazolam group by 7.95
points.2 Ketamine’s success for treating major depression due to its ability to help minimize
Ketamine has many uses across the medical field, such as anesthetics, veterinary
practices, and to treat depression. Not only can it be used for many purposes, it can also be
administered in many ways: orally, intravenously, and through a sedation mask. Even though
Ketamine is still being tested for the treatment of other diseases and disorders, the future of
ketamine usages looks to be expanding in the near future.
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References

1. Ajp.psychiatryonline.org. 2020. Antidepressant Efficacy Of Ketamine In

Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial |

American Journal Of Psychiatry. [online] Available at:

<https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2013.13030392>

2. Sleigh, J., Harvey, M., Voss, L. and Denny, B., 2020. Ketamine – More Mechanisms

Of Action Than Just NMDA Blockade.