12 ms·
Is Ketamine Neurotoxic?
- d1sxeyes 2y ago> However, the average ketamine “user” consumes 500-1000mg of ketamine per day, which is 100-300x as much as therapeutic use (0.5mg/kg) For users weighing one kilo. For users of a more normal weight, you’re off by an order of magnitude.
- daeken 2y agoThe author clarifies later that the listed therapeutic dosage is weekly rather than daily, so that's 3500-7000mg/week versus 35mg/week for an average person (from a quick Google, 70kg). Not sure where the 300x is coming from, since that's an average body weight.
- pantalaimon 2y ago1g/day is a pretty extreme dose, even disregarding that most users don't consume it daily.
- quchen 2y agoIt is however not unheard of, or even uncommon. With moderate tolerance, binging a couple of hours will reach the 1g threshold quite quickly. Ketamine tolerance upon continued use can reach some really wild levels. I’ve worked with people who reported that a 1g single dose nasally won’t get them properly high.
- amarcheschi 2y agoWow, I googled and the dose for horses is about 2 to 5 mg/kg
- quchen 2y agoIt’s the same dose (per body mass!) for humans, and ketamine is heavily used in human medicine for similar reasons. The main difference is that for horses it’s mostly used as an anesthetic, while for humans it’s also used at lower doses as an analgesic (pain reliever).
- amarcheschi 2y agoYeah but I mean, 1g is a 200kg human dose in the best case. That's a lot
- malfist 2y agoWhen I severely dislocated my shoulder the hospital sedated me with ketamine and propofal. They'd already given me the max dosage of morphine and fentanyl to get me to be able to barely sit up for an X-ray. So I'd say it's used in humans for anesthetic too. And guys, I'd the doc says after your first dislocation you should have the surgery to prevent it from happening again, you should listen to them so you don't spend a night in excruciating pain three months later. For what it's worth, when I came too I felt like I was black out drunk, not a good experience for a previous alcoholic
- farbklang 2y agoIt should be noted that in this example we are comparing insufflation vs injection, which has a very different bioavailability and effect on the body. I think for therapy with humans it is also given as a nasal spray.
- amarcheschi 2y agoOh definitely, I thought about writing about it but omitted it, I should have added it earlier
- d1sxeyes 2y agoYeah, I'm not sure that 'weekly' is true either, most of the research I've done says 0.5mg/kg is a single 'dose', rather than anything timebound. A lot of the protocols seem to indicate that twice weekly is the most common dosing, but it depends on the usage: https://www.drugs.com/dosage/ketamine.html https://www.drugs.com/dosage/ketamine.html says 1-4.5mg/kg for anaesthesia, with more as needed to maintain https://reference.medscape.com/drug/ketalar-ketamine-343099 https://reference.medscape.com/drug/ketalar-ketamine-343099 says 0.5mg/kg for depression off label, repeated twice weekly. https://dancesafe.org/ketamine/#:~:text=30-60%20mg https://dancesafe.org/ketamine/#:~:text=30-60%20mg says that the common recreational dose is 30-60mg, so the number mentioned by the author is between 50 and 250 'bumps' a week? I'm not familiar with ketamine usage, but that seems to be a very high number.
- GordonS 2y agoROA (route of administration) also matters, and those figures you've given appear to be a mix of IV (intravenous) and IM (intramuscular) injection doses. Many recreational users insufflate (snort) ketamine, and that ROA has much lower bioavailability than IM or IV - IIRC, it's something like 20% for insufflation, 80% for IM, and 100% for IV. Thus, you need a much higher dose for snorting.
- d1sxeyes 2y agoI agree. The article is unclear though. For recreational users snorting (I think it's 'insufflate', rather than insulate), the DanceSafe link is clear that that's the method (it says 'snort 30-60mg'). As you say, you'd expect users to need a much higher dosage for snorting than IV. Either way, the article has since been silently updated to remove the 100-300x claim that I took issue with, so either I, or someone else, managed to get the point across to the author.
- GordonS 2y ago> I think it's 'insufflate', rather than insulate Haha, auto-correct strikes again!
- pantalaimon 2y agoKetamine Georg, who consumes 420 kg of Ketamine per day, is an outlier and should not be counted.
- rob74 2y agoYou can (try to) consume 420 kg of Ketamine one day, but you surely won't be able to repeat it the next day...
- pantalaimon 2y agohttps://en.wikipedia.org/wiki/Spiders_Georg https://en.wikipedia.org/wiki/Spiders_Georg
- wizzwizz4 2y agoThat's a therapeutic dose for users weighing one to two tonnes. I don't think they're off by any orders of magnitude.
- cactusplant7374 2y agoThey are confusing oral vs. IV. There are different amounts of ketamine used for different ROA's. Typical dose for prescribed lozenges is 200-250mg.
- Aurornis 2y agoThere are many things wrong with the claim, but even the math doesn’t make sense. 0.5mg/kg for a 70kg person would be 35mg, which is not 100-300X less than the 500-1000mg number. The claim isn’t even close to mathematically correct. It’s also easy to find clinics giving IV or IM doses at significantly higher rates. This entire article does not leave a good impression, to be honest. It feels like the author started with one conclusion and then made assumptions to fill in the blanks to write the article.
- Aloisius 2y agoNow it says: > However, a heavy ketamine “user” often consumes multiple grams per week, which is a lot more than therapeutic use (0.5mg/kg about once per week to every other week).
- redrove 2y ago[flagged]
- jeltz 2y agoIs it actually known if he regularly uses ketamine? I have seen lot of claims but never any source.
- actionfromafar 2y agohttps://www.youtube.com/watch?v=NH4_rcq4jgQ https://www.youtube.com/watch?v=NH4_rcq4jgQ Bloomberg https://www.youtube.com/watch?v=SC2Z0mb1W2A https://www.youtube.com/watch?v=SC2Z0mb1W2A interview But I'm sure he uses in moderation, he's a very balanced and stable guy. Definitely not enough to cause bladder issues.
- mexicocitinluez 2y ago> But I'm sure he uses in moderation, he's a very balanced and stable guy. This is a joke, right?
- joquarky 2y agoPoe's law is dead.
- poincaredisk 2y agoI don't follow world events too much. I know who Elon is, but I have no idea about his personality and stability. I consider myself pretty sensitive to sarcasm over the internet, but I completely missed that. I don't really mind not understanding that joke, since I don't really care about internet celebrities anyway, but that's an example how someone (hopefully) averagely smart can miss a joke like that.
- DonHopkins 2y ago
- floppiplopp 2y ago[flagged]
- amelius 2y agoBeen seeing a lot of these in the news lately.
- croisillon 2y ago[flagged]
- goodpoint 2y agos/autistic roman/nazi/
- LiKao 2y agoDon't forget really bad jokes, such as making your product line spell out se*y and naming stuff after memes.
- askl 2y ago> such as making your product line spell out se*y Especially with exterior designs ranging between boring and ugly.
- mysterydip 2y agoOne time I took side views of each of them and scaled them all to the same size based on wheelbase. They're literally all the same design, just stretched. That's why they look so bad, in the same way a corvette would look bad stretched into an SUV.
- matthewdgreen 2y agoBring back dorky middle-school sense of humor Musk. I’m fine with S*XY and fart mode and even flamethrowers. If you can find a history of Musk headlines through the years you see that almost everything before 2018 is just dorky engineer stuff and jokes, and then post-2018 it’s mean and destructive.
- johnisgood 2y agoIt is not neurotoxic, in fact, it is the opposite due to it being an NMDA receptor agonist (neuroplasticity). I thought we have known this for a long time. It could be, in very high doses. Just like you can die from water intoxication too.
- cess11 2y agoYou might want to take a look at https://pmc.ncbi.nlm.nih.gov/articles/PMC3713393/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3713393/. In animal models it also seems like the dopaminergic effects are strong enough to cause midbrain downregulation and lower dopamine neuron density. If you've ever taken ketamine recreationally you've likely noticed the very strong dopaminergic effects, though maybe not been able to classify them as such.
- johnisgood 2y agoI have taken smaller, and larger doses of ketamine before, I personally did not experience the claimed strong dopaminergic effects. What was I supposed to experience for this dopaminergic effects? Maybe I could tell you.
- cess11 2y agoAt dissociative doses ketamine typically induces a strong feeling of expectation, of something fantastic or important being imminent, things like that. To some people this takes a religious form, like (almost) coming into communication with some ethereal being or (almost) reach some mystical insight. It can cause a strong urge to redose. Do you recognise any of this?
- johnisgood 2y agoI went into a k-hole (a few times) where I was seeing myself from the outside (with all my flaws and faults being shown to me), and I remember my then-girlfriend slipping away from me and I tried to grab into her but she slipped away, and I remember being locked in time (not sure how to explain it). I did DXM too, that was less clean than ketamine and DXM had more of an alienish-vibe to it and I ended up watching Stargate Atlantis on it, that was fun, but ketamine had me self-reflect quite a lot. About expectations & imminent, it made me want to change the way I live as I am pretty much a reclusive. I wish I could explain it better but I really can't. I never felt an urge to re-dose, however.
- throwaway835174 2y ago> Nonetheless, it’s widely recognized that individuals who occasionally use ketamine find they need significantly higher doses than when they first started, even after prolonged periods of abstinence. Sorry for the slight divergence from the focus on ketamine, but more generally, does anyone know if this applies to other medications that alter the brain's function? I've noticed the same phenomenon with the adderall I am prescribed for ADHD, and despite the tolerance buildup and the offer from my psychiatrist, I refuse to bump up the dose further due to fears of long-term changes in the brain. Honestly, I'm considering ditching it altogether after about a decade of prescription because I become more paranoid over time about unknown, long-term effects. Posts like this about ketamine don't help my suspicions.
- colechristensen 2y agoIf you give it a break the adderall tolerance goes away. It’s good to regularly skip days. Ketamine abuse is particularly dangerous compared to so many things, particularly amphetamines taken at therapeutic doses which is safe to the level of no particularly clear long term effects.
- ycombinete 2y agoI looked into this a while back, and found some reviews from some branch of the Canadian health authorities, that said that euphoric effect of methylphenidate fades more with tolerance than the therapeutic effect. So you will still be getting some adhd related benefits from it, even if you're not feeling that little rush that you felt when you first started taking it. Like the other commentator, I do like to skip some days occasionally (mostly on weekends). I usually see on day 1 that I was most definitely getting some benefit from it the day before, even when it didn't feel like it.
- ykonstant 2y agoIn general you should listen to your doctor for these things; if they say that an increase in dosage is recommended, listen to them. Although I am not very sure about the word "offer". What do you mean "offer" from your psychiatrist? If you are worried about long term effects of stimulant medication (which is a very valid worry), you may want to ask your doctor for an intermittent schedule. Sadly, as we know, many of us need the medication to function reasonably in daily life. However, if you are building tolerance to the medication, it is probably worth it.
- Dlooooloo 2y agoCrazy I took it on a few evenings over the last few years and he just takes it every day/week? For sleeping? Relaxing?
- colechristensen 2y agoI spent some time around a ketamine abuser and it was shocking how he seemed like… at one point he was a very capable and knowledgeable person and how much was just gone.
- Muromec 2y agoI know a person who was doing it a lot and then stopped. It seems that at least the illusions of grandeur and the usual spiritual nonsense are not a permanent thing.
- byyoung3 2y agolots of compounds are neurotoxic when taken in large doses, but completely safe when taken in lower doses. This isn't really surprising
- portaouflop 2y agoThe point here is that the majority of people who take Ketamine take way more than the safe dosage especially when taken recreationally (without a physicians oversight).
- siva7 2y agoThe majority? I doubt that claim.
- dplgk 2y agoIs it not assumed all recreational drugs cause or have the chance to cause damage to the body? I always assumed it was a trade off of some temporary fun for x% damage to the body or x% increased chance of disease.
- kmmlng 2y agoWith many drugs that are used both therapeutically and recreationally, it is the case that the average recreational dosage is much larger. Ketamine is an exception here, as therapeutic doses are actually quite high. The common mistake here is to equate intravenous dosage with intranasal dosage, when the bioavailability differs significantly between these routes of administration. And that's not even considering that most reported recreational dosages are wrong due to cutting agents. There certainly is recreational abuse with very large dosages, but I don't think it's fair to claim that the majority of users fall into this category.
- TeaBrain 2y agoAll things are not necessarily equal in this regard. NMDA antagonists, of which ketamine is one, are well-known for their neurotoxic potential.
- alecst 2y agoRegarding lesions, a recent pair of articles about Ibogaine. https://pubmed.ncbi.nlm.nih.gov/39981248/ https://pubmed.ncbi.nlm.nih.gov/39981248/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11303312/ https://pmc.ncbi.nlm.nih.gov/articles/PMC11303312/
- zug_zug 2y agoI'm finding this draft article pretty confusing, and am not sure why it's shared in its current state. I think it should also cite sources. > "However, the average ketamine “user” consumes 500-1000mg My impression was that the majority who try ketamine do it a handful of times in their whole lives, usually <200mg.
- rsynnott 2y agoThey almost certainly mean habitual user.
- rscho 2y agoEverything acting on the brain is neurotoxic at sufficient doses. However, I would be far more worried about cardiovascular effects, for which life threatening complications are much more immediate.
- cactusplant7374 2y agoKetamine is widely used and it's very difficult to find deaths. Sure, one can die by taking it and getting in a hot tub or using it with other drugs. But on its own its safety profile is better than acetaminophen.
- rscho 2y agoAcetaminophen is often chosen as a suicide drug because of its narrow therapeutic index. I don't think that means abuse of ketamine is that safe, having administered a lot of it. The effects at anesthetic doses are pretty spectacular.
- cactusplant7374 2y agoWhy aren't there huge numbers of deaths attributed to ketamine if it's unsafe? Ketamine is quite popular. When you look at opioids it's easy to find fatal overdoses.
- rscho 2y agoI agree for opioids. And I'm certainly not saying there are 'huge numbers of deaths' linked to ketamine. Maybe specialK is popular where you live, but here long term ketamine habits seem quite rare, based on my totally unscientific impression. I also think ketamine abuse isn't very much studied, at least compared to more popular drugs. What I'm saying is that while a short term stint into ketamine probably isn't a big deal, I expect long term use with higher dosage ('ketamine hole', tolerance and all that) to be more dangerous. Having your blood pressure peak in the 250's can't be that safe when you start aging.
- MavisBacon 2y agoIt's also worth noting that ketamine does appear to increase neural plasticity and can promote the formation of new synaptic connections (synaptogenesis), particularly in areas of the brain involved in mood regulation. That being said, I too have experienced tolerance with ketamine infusions- even with a month between doses. Always found it a bit troubling and I'd rather not have to continue to increase the dose.
- malfist 2y agoThe article talks about that. That's just not true in medical literature
- 317070 2y agoI can recommend everyone to read Felix Hill's suicide note on the topic. He was a scientist in DeepMind: https://docs.google.com/document/d/1-jBoSEVlryiX1IaSzV4vKuihDfm_LgXUznvSpl1T1kg/mobilebasic https://docs.google.com/document/d/1-jBoSEVlryiX1IaSzV4vKuih...
- hn666 2y agoFucking hell
- dilawar 2y agoFucking hell indeed. I couldn't read the whole thing, only the first couple of pages.
- krthr 2y ago:o
- elric 2y agoNot quite sure why he thought ketamine would be safer than LSD. Maybe because the local pharmacy carries it?
- tycho-newman 2y agoPhysician supervised ketamine therapy has worked wonders for people with PTSD, at least one of whom I know personally. Otherwise, street ketamine can be adulterated with anything. It is dangerous.
- almog 2y agoMy first thought too. Don't know if it would have made any difference in the end result but LSD and Psilocybin Mushrooms are ranked much safer than Ketamine and unlike Ketamine, aren't addictive. When I saw the Psychedelics headline I was expecting these two plus maybe DMT. Some people consider Ketamine as psychedelic drug but it's really a dissociative drug.
- jerrygenser 2y ago
- H8crilA 2y agoRegardless of the answer to the question posed here keep in mind that high powered psychiatric interventions can be very effective, even if they don't last forever. Whether it's ketamine or electroconvulsive therapy - it's certainly better than suicide. At least promise yourself to try such things first (in a hospital setting! yes they have those in hospitals in developed countries) before you make the conclusion that your life has become too painful to live it. PS. there are many other treatments that doctors may give you before reaching for the big guns; those can be very effective too.
- gehwartzen 2y ago>PS. there are many other treatments that doctors will give you before reaching for the big guns; those can be very effective too. This part can sometimes be difficult if you are in crisis. There’s lots of other options like you mention but they tend to take longer to see an effect. Ketamine can be very immediate in that regard. I remember it being like a light switch and thinking “wow this is how others must feel!”. And just seeing, even once, that it is at least chemically possible for your own brain to work/think like that can be very inspiring and hopeful esp when it feels like it hadn’t been worked correctly for a long time (or ever)
- sizzle 2y agoHow would you compare this feeling with taking psilocybin?
- blogabegonija 2y agoMy personal experience. With ketamine you can see/feel your problem outside of you in many ways. With psilocybin you can dive straight into problem's answer. Both ways can terrifing. Also It can be unpleasant or rewarding. If that makes sense.
- sizzle 2y agoThanks. Some day I will have the courage to try. Until then Erowid
- hoseja 2y ago>At recreational doses >already after three months of high-dose ketamine use Recreational?
- tycho-newman 2y agoKetamine taken under the supervision of a physician is an effective treatment. I have seen its effects with my own eyes. Do not fuck around with street drugs. If the FDA didn't approve it, there could be anything in it.
- mallomarmeasle 2y agoFor anyone interested in the therapeutic (or otherwise) use of ketamine, I strongly recommend the autobiography of John Lilly, the neuroscientist who developed the sensory deprivation tank. His discussion of ketamine-aided spiritual entity discovery and dolphin communication are enlightening. https://archive.org/details/scientistnovelau00lill/page/n5/mode/2up https://archive.org/details/scientistnovelau00lill/page/n5/m...
- InDubioProRubio 2y agoAll drugs build up resistance, making a increasging of dosage necessary, and dosage maketh the poison. You might start out with a PTSD-tracking app, pumping a microdose of Keta via a insulin-pump every time the eldritch horror of reality hits you again and again, but you will still need to crash out of it regularly ever n months. Its a high-functioning half-life, but preferable to the alternatives?
- cactusplant7374 2y ago> Ketamine abuse is well known to cause widespread cognitive and neurological impairment. However, the average ketamine “user” consumes 500-1000mg of ketamine per day, which is a lot more than therapeutic use (0.5mg/kg). One glass of wine per week is surely different from a gallon of vodka per day. Author is mistakenly comparing oral vs. IV routes. Of course the amounts are different because metabolism is different. How can they pontificate and make such a mistake?
- superb-owl 2y ago> However, the average ketamine “user” consumes 500-1000mg of ketamine per day This is an outrageous claim with no citation. I'm a regular user, and this is roughly what I consume per month, if I'm going hard
- plsbenice34 2y agoAgreed. It's an absurd dose assumption. According to Erowid, a common dose is 30 mg to 75 mg. I spent some time reading papers about ketamine before, and it seemed that all the negative side-effects (like bladder damage) are only ever observed in extreme cases where someone takes massive, abnormal doses for an extended period of time. I think it is not relevant to the vast majority of recreational users.
- __MatrixMan__ 2y agoI once did 75mg in a session and left with the feeling that that was way too much. I can't fathom 500.
- Gibbon1 2y agoStupid raver trick layout a line of K like it's coke and snort it.
- __MatrixMan__ 2y agoI thought that was the normal way. I guess that makes me a stupid raver? I was introduced by a hippie I met in the woods.
- siva7 2y agoIt feels like a low-quality article in which the author is writing about a scientific topic but has no qualifications or expert knowledge (and therefore making wrong conclusions due to their lack of understanding around the research they cite). I don't understand why people feel the need to publish such blogs.
- sweezyjeezy 2y ago
- puppycodes 2y agonot a neurologist but pretty sure your "gut feeling" isn't science.
- deleted 2y ago[deleted]
- golergka 2y agoReading through the article and comments, it seems like there's a lot of confusion about what is considered "a user" and what typical dosages are. Obviously, a rave fiend who used to do MDMA twice a week and coke at least 5 and then moved to K would consume, completely disregarding this health but still staying conscious enough to continue dancing on a dance floor. At the same time, a tech worker who does Yoga, goes to Burning Man every year and have a long and productive relationship with psychedelics probably does a very K every 1-2 years in the right set and setting, but consumes a dose high enough to venture deep into the K-hole to seek some mystical answers — just as he does the same with DMT and other exotic Shulgin creations. From the anecdotal data (including the tragic suicide note that pops up on HN every now and then) and sporadical research, it's very unclear how much danger does the second scenario actually entail.
- josefritzishere 2y agoI have read that Ketamine destroys grey matter. Is that true? Elon certainly makes it look true.
- meifun 2y agoare everyday people even prescribed Ketamine in the USA? Or is it just people that can afford to buy it outright from a non=pharmacy source?
- kennyloginz 2y agoIt’s the rich people.
- desert_rue 2y agoThere are startups.
- gremlinsinc 2y agoI'm in Medicaid in Utah. I'm taking 70mg in a hospital setting once per week for about 7 to 10 weeks combined with therapy. Medicaid copay is only $20.
- funnym0nk3y 2y agoAlthough everything seems to be researched thoroughly there are many mistakes. Mistakes that are pretty basic (like Venlafaxine having it's origin in an amphetamin instead of tramadol) and lead me to the assumption of sloppy work. In addition study results are stated as facts whereas reproducibility is very poor in psychiatry. In addition microdosing escitalopram at like 2,5mg/d seems like it is mostly placebo. When introducing a drug there are dose response studies done, that determined that ESC needs 10mg for most people to be effective against depression. Same with 2,5% of the starter selegiline dose. I think the texts of this author need to be viewed with much caution.
- fallingfrog 2y agoWell I’m convinced at least that there is potentially a significant danger. I’ll stick to microdosing shrooms.
- snortabart 2y ago[flagged]