Ketamine Overdose Symptoms, Treatment & Long-Term Outlook
Ketamine is a dissociative anesthetic with a potential for recreational misuse.1 Ketamine overdose has numerous troubling symptoms that can impact mental and physical functioning.2 Recent studies have cited a worldwide increase in ketamine misuse, so it’s becoming more critical to understand the potential adverse effects of using this drug.3,4
What is Ketamine Overdose or Toxicity?
Ketamine is a powerful dissociative anesthetic that can make people feel detached from things like pain sensations and other environmental elements.5 Though pharmaceutical use in both human and veterinary medicine exist, there are many potential adverse effects of ketamine misuse, including the potential for dose-dependent toxicity, or ketamine overdose.2
At relatively low doses, ketamine alters perception and coordination, accompanied by producing a dream-like way of thinking and euphoria.2,6 As doses increase, the person using may begin to feel a complete separation from reality, or a so-called “out of body” experience.6 Markedly unpleasant dissociative experiences such as these are sometimes known as a “near-death” experiences or the “K-Hole.”6 Loss of consciousness can also occur at high doses.6
High doses of ketamine can result in several health issues, including respiratory, cardiovascular, and neurological toxicity. Some of the wide-ranging adverse risks of ketamine misuse include:2
- Elevated blood pressure.
- Breathing difficulties.
- Problems with coordination and judgment.
- Ulcerative cystitis.
Death by ketamine overdose rarely occurs if ketamine is the only drug someone takes.6 However, fatal toxicity may be more likely when someone combines ketamine with alcohol, as both substances impact respiration and cardiovascular functioning.3 Combining alcohol with ketamine has also been linked to a risk for severe neurotoxicity.7
Furthermore, ketamine use may be associated with accidental injury and death.2,6 This can involve falling, drowning, vehicular accidents, and hypothermia.2,6 One study of deadly motor vehicle collisions found a disproportionately large number of ketamine-involved accident fatalities compared to other substances like opioids and alcohol.2
Ketamine Overdose Causes & Risk Factors
Studies are still ongoing regarding ketamine dosage and toxicity, and the information available on this topic is limited, especially for human subjects.2 Recreational use may entail relatively high doses of the drug to elicit a desired level of intoxication, and such high dose use can increase the likelihood of ketamine overdose symptoms.1,2
Certain medical conditions can also exacerbate the risk of ketamine toxicity. For example, issues such as pre-existing heart disease and/or hypertension can increase a person’s risk of cardiovascular complications in association with ketamine toxicity.2 This can lead to issues such as increased intracranial pressure, an increased risk for stroke, and diminished blood flow to heart muscle (i.e., myocardial ischemia).2
Ketamine Overdose Treatment
Medical monitoring may be necessary when someone experiences symptoms of a drug overdose. A single dose of ketamine can last from 15 minutes to many hours.2 Because of the unpredictability of this drug’s effects, someone under the influence of ketamine should be monitored 6 hours after reported ketamine use even if asymptomatic and monitored 1–2 hours after the last symptom is seen.2
Ketamine overdose treatment consists primarily of supportive care, though more severe cases may require the patient to be placed on a monitor.2 Intubation may be used if respiratory support is needed.2 Ketamine overdose reversal is not possible via any known medication at this time.2
Doctors can use activated charcoal in a supervised medical setting to help with gastrointestinal detox in a ketamine overdose, if this is deemed necessary.2 Medications can be used in an emergency room to mitigate some of the psychiatric and medical ketamine overdose symptoms.2
Once someone has been medically stabilized from a ketamine overdose, this may be an ideal time to speak to them about the benefits of seeking substance misuse treatment regarding their ketamine use (or use of other drugs). Continued misuse of ketamine can be dangerous; addressing the behavioral aspect of ketamine misuse through professional intervention could be a valuable tool in preventing these dangers from being realized.
Ketamine Overdose Outlook & Prevention
A person that experienced and recovered from acute ketamine toxicity may experience psychological disturbances, including hallucinations and unusual dreams, for days or weeks after their last use.2 These effects are not considered to be permanent and fade with time.2 Frequent ketamine use, however, has been linked to long-term depression, sleep problems, and deficits in memory and concentration.2
Psychological dependence has also been found in long-term use of ketamine, despite the absence of physical withdrawal symptoms.2 If you are concerned about the possibility of drug dependence, it may be time to seek professional help. Medication, outpatient, and inpatient treatment are generally available to address the health effects of addiction including ketamine misuse.
The best way to prevent ketamine overdose and addiction is to avoid recreational ketamine use. If you or someone you care about need some help with ketamine or other substance misuse, please call our admissions navigators today at .
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- Morgan, C.J.A., & Curran, H.V. (2011, July). Ketamine use: A review. Addiction, 107, 27–38.
- Urhurhu, V.J., Vashisht, R., Claus, L.E., & Cohen, S.P. (2022, April). StatPearls: Ketamine toxicity. National Library of Medicine.
- Kobayashi, N.H.C., Farias, S.V., Luz, D.A., Machado-Ferraro, K.M., Conceicao, B.C.D., Silveira, C.C.M.D., …, & Maia, C.D.S.F. (2022, July). Ketamine plus alcohol: What we know and what we can expect about this. International Journal of Molecular Science, 23(14), 7800.
- Strous, J.F.M., Weeland, C.J., van der Draai, F.A., Daams, J.G., Denys, D., Lok, A., …, & Figee, M. (2022, March). Brain changes associated with long-term ketamine abuse: a systematic review. Frontiers in Neuroanatomy,16, 795231.
- Drug Enforcement Administration. (n.d.). Ketamine drug fact sheet.
- Dinis-Oliveira, R.J. (2017, February). Metabolism and metabolomics of ketamine: A toxicological approach. Forensic Science Research, 2(1), 2–10.
- Zuo, D., Sun, F., Cui, J., Liu, Y., Liu, Z., Zhou, X., …, & Wu, Y. (2017, September). Alcohol amplifies ketamine-induced apoptosis in primary cultured cortical neurons and PC12 cells through down-regulating CREB-related signaling pathways. Scientific Reports,7(1), 10523.
- Mikkelsen, S., Ilkjaer, S., Brennum, J., Borgbjerg, F.M., & Dahl, J.B. (1999, June). The effect of naloxone on ketamine-induced effects on hyperalgesia and ketamine-induced side effects in humans. Anesthesiology,90, 1539–1545.
- Yang, C., Si., M., & Zhou, J. (2021). Silencing TRPV4 partially reverses the neurotoxic effects caused by excess ketamine. Journal of Toxicological Sciences, 46(2), 69–81.
- Chan, Y.C. (2012). Acute and chronic toxicity pattern in ketamine abusers in Hong Kong. Journal of Medical Toxicology, 8,267–270.
- Kalsi, S.S., Wood, D.M., & Dargan, P.I. (2011, April). The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerging Health Threats Journal, 4, 7107.