Ketamine is gaining increasing attention for its effectiveness in treating conditions like depression, anxiety, PTSD, and chronic pain. Originally developed as a surgical anesthetic, its ability to offer rapid symptom relief has made it a promising tool in mental health care and pain management. However, as with any medication, it’s important to be informed on the possible side effects.
While many of these side effects are mild and short-lived, others can be more noticeable, especially for people new to ketamine therapy. In this blog post, we’ll break down the most common side effects of ketamine (at the dose and frequency indicated for mental health and chronic pain) and what you can expect if you are considering or currently undergoing treatment.
1. Dissociation and Altered Perceptions
One of the hallmark effects of ketamine is its ability to produce dissociative sensations. For many people, this means feeling detached from their own body or reality, a sensation known as "out-of-body" experience. While some individuals find this aspect of ketamine therapeutic, others may feel disoriented or confused by the altered state of consciousness. These effects fade as the drug’s influence wears off. It is important to note that an enjoyable “trip” is not necessary for patients to experience an improvement in their symptoms.
What to Expect:
A feeling of disconnection from your body
Changes in perception of time and space
Visual or auditory distortions, such as colors or sounds seeming more intense
Seeing shapes and colors when your eyes are closed
Feeling as if your body is sinking into the chair or other sensations of motion
A feeling of connection with the universe, other people, yourself or a knowingness
2. Dizziness and Lightheadedness
Many people who undergo ketamine therapy experience dizziness or lightheadedness, particularly when standing up or moving around. This effect is usually temporary, but it can be uncomfortable. Fortunately it is almost entirely avoidable if the patient remains seated until they have returned to their baseline state.
What to Expect:
A sensation of feeling faint or unsteady
Lightheadedness that improves after resting or lying down
3. Nausea and Vomiting
Another relatively common side effect of ketamine is nausea and vomiting. If you’re someone who is generally sensitive to nausea, it is best to let your provider know so they can prepare you with the necessary medications which is typically sufficient to head off any issues.
What to Expect:
Feeling queasy or nauseous
Occasional vomiting, particularly as the drug’s effects begin to wear off
Car sickness on the ride home. If you are prone to car sickness be sure to ask for an additional dose of an ant-emetic and take some emesis bags in the car with you.
4. Increased Heart Rate and Blood Pressure
Ketamine can cause a rise in heart rate (tachycardia) and blood pressure. While this is almost always temporary and not harmful for most individuals, it can be concerning for people with pre-existing heart conditions. Healthcare providers typically monitor vitals before administering ketamine, to confirm it is safe to proceed, and again when the infusion is over to ensure your vitals have returned to baseline.
What to Expect:
A faster heartbeat
A slight increase in blood pressure
Your care team coming to check on you and check your vitals as needed
5. Hallucinations
Although not experienced by everyone, ketamine can sometimes cause vivid hallucinations but only while the medicine is in your system. These visual or auditory distortions can range from minor changes in color or light to full-on hallucinations. While some users find these experiences intriguing or enlightening, others may find them disorienting or unsettling. It is important that the patient communicates any unpleasant sensations or emotions because there are many things your provider can do to rectify this.
What to Expect:
Distorted or “warped” visual or auditory perceptions
Brief experiences of seeing things that aren’t there (typically shapes, colorful patterns, some patients describe it as a kaleidoscope or a laser light show)
These effects disappear once the session is over and the medicine leaves your body
6. Blurred Vision/Sensitivity to light
Temporary changes in vision, such as blurriness or double vision, are another side effect commonly associated with ketamine. This can be particularly noticeable when trying to focus on nearby objects or reading during the drug’s effects.
What to Expect:
Blurred or double vision, which typically resolves shortly after the treatment
7. Sedation or Fatigue
As the effects of ketamine begin to wear off, patients often report feeling extremely tired or sedated. This sense of fatigue can be strong and may persist for a few hours after the treatment session but this nearly always passes after a good night sleep. It is important to avoid any activities that require alertness (like driving) after a ketamine infusion.
What to Expect:
Deep tiredness or a desire to rest
Difficulty staying awake or focused right after the treatment
8. Memory Issues
It is uncommon but some individuals report having memory lapses or a sense of "not remembering" parts of the infusion experience.
What to Expect:
Difficulty remembering parts of the session
Memory issues are short-term and resolve once the ketamine has left your system
Final Thoughts
Ketamine offers many promising benefits, especially for people struggling with treatment-resistant conditions like depression or PTSD. However, understanding the common side effects can help prepare you for the experience and ensure you’re making an informed decision.
Most of the side effects associated with ketamine (at the doses and frequencies used in an outpatient setting) are mild and temporary, with many people experiencing only one or two of the effects mentioned above. In most cases, these side effects subside quickly after the treatment session ends. However, if you have pre-existing health conditions or are concerned about the side effects, be sure to discuss any concerns with your healthcare provider before undergoing ketamine therapy.
Remember, while ketamine is a powerful tool in mental health and pain management treatment, it’s important to always be under the care of a medical professional when using the drug. This ensures that any side effects are appropriately managed and that you’re getting the most benefit from your treatment.
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