By Emily Ledger
Ketamine was first synthesised in 1962 as researchers looked for an alternative to phencyclidine – more commonly known as PCP or ‘angel dust’. Since then, it has been used by millions around the world for both medical and recreational purposes – but what actually is it?
Following early research into ketamine, the drug became known as a ‘dissociative anaesthetic’ due to its psychoactive effects and ability to induce unconsciousness. However, studies also identified some odd effects when the drug was taken in low doses.
In 1964, two years after the first synthesis of the drug, a doctor named Edward Domino conducted the first human trials of ketamine on inmates at Jackson State Prison, in Michigan. While the substance was observed to be a powerful sedative at higher doses, lower doses appeared to separate the mind from the body, having some strange effects on the participating inmates.
Despite these findings, the focus was placed on the sedative and anaesthetic potential of the drug as opposed to its psychotropic properties. It was soon to become a common anaesthetic in medical rooms.
Ketamine in a Medical Setting
As an Anaesthetic
The FDA approved ketamine as an anaesthetic in 1970, just as US legislation was to be introduced banning psychotropic substances such as LSD and psilocybin. Ketamine was widely used by the US military in the Vietnam War and is still a standard anaesthetic used in medical settings around the world.
Not much later, researchers and medical professionals began to notice other interesting properties of ketamine. Clinicians at Yale University in the US used ketamine to mimic the symptoms of schizophrenia – however, they also noticed that the drug also seemed to improve the mood of participants. This led to the assessment of the substance as a possible treatment for depression.
As a Treatment for Depression
As ketamine is licensed for use as an anaesthetic, it can also be used off-license for other applications – most notably as a treatment for depression.
In 2006, the National Institute of Mental Health (US) concluded that ketamine had rapid antidepressant effects. Since then, hundreds of studies have been carried out in this area – many of which suggest that a single dose of ketamine can relieve symptoms of depression for days and even weeks. Interestingly, researchers also observe that talking therapies (a common treatment option for patients with depression) tend to be more effective during this period.
A recent study (published in June 2020) found that a single low dose of ketamine was associated with an increased number of serotonin 1B receptors. Participating patients had been diagnosed with difficult-to-treat depression, following the inability of common antidepressant treatments – such as selective serotonin reuptake inhibitors (SSRIs).
Serotonin is a chemical produced naturally in our bodies to send signals between nerve cells. It has been found to contribute to mood regulation and feelings of wellbeing. While SSRIs work by increasing serotonin levels, this may not be an effective treatment for depression if there are still not enough receptors to ‘catch’ these compounds. Increasing the number of serotonin receptors can also lead to the more efficient release of another ‘feel-good’ chemical – dopamine.
Ketamine is also considered a rapid treatment option in emergency situations for acutely suicidal patients.
Thanks to this impressive potential, a number of clinics offering ‘ketamine-assisted therapy’ are popping up around the world. Last year, Bristol welcomed the UK’s first ketamine clinic – the Awakn Clinic. Prior to this, however, a number of clinics had begun to offer ketamine-assisted therapy across the US and other countries.
Ketamine as a Recreational Drug
In addition to these impressive medicinal properties, ketamine also has powerful psychotropic effects that have made it an increasingly popular drug for recreational users.
Often labelled a psychedelic drug – despite the efforts of early investors and researchers to avoid the drug being linked with other substances that had quickly become associated with counter-culture movements and recreational drug use – it wasn’t long before the drug was adopted by party-goers and ravers.
Recreational users more commonly snort the drug in lower doses in order to experience distortions to reality while still being capable of social interaction. However, when taken at higher doses, ketamine’s sedative effects can cause users to become unresponsive and appear unaware of their surroundings. This is referred to as being in a “K-hole”.
The Future of Ketamine
So, while ketamine’s psychoactive properties have at times made this drug controversial, its striking potential in the treatment of mental illness, as well as its ongoing use as an anaesthetic, appear to have secured the drug’s place as an important medical product.
As governments and private and public investors continue to fund research into alternative treatments for mental illnesses, including depression and addiction, ketamine is expected to be a key drug in the ongoing ‘psychedelics renaissance’ that is in full swing around the world.
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