How Is Ketamine Made?
Whether you’re someone who works in medicine, someone who suffers from anxiety and depression, or are simply curious about psychedelics as an alternative treatment, you’ve probably read articles about the benefits of ketamine therapy. Known as a dissociative anesthesia, the drug is gaining popularity for a variety of mental health and chronic pain issues.
Contents of this article
What Is Ketamine?
This anesthetic medicine often gets a bad rap for its use on animals, namely horses and large cats like tigers. However, it also has FDA approval for use in humans, either alone or in combination with other drugs.
“It is quite helpful as a short-term sedation for medical procedures where skeletal muscle relaxation is not needed as well as a pre-anesthetic for induction of general anesthesia,” says Dr. Rashmi Byakodi, health and wellness expert for Bestfornutrition.com.
Another benefit of ketamine gaining popularity is its use as a treatment for a range of mental disorders. This includes depression and suicidal tendencies, particularly when paired with psychotherapy.
In fact, research, including one study published in the Journal of Psychoactive Drugs, has shown that the psychedelic implications brought on by ketamine can be equally, if not more, important than its biological effects.
“Ketamine is known to act at the brain’s N-methyl-d-aspartate receptors, but the exact mechanism by which ketamine assists in recovery from certain mental disorders remains under active investigation,” explains Joe Flanders, Ph.D., psychologist and founder and director of Mindspace.
“Through these psychedelic effects and psychotherapy, ketamine can induce neuroplasticity. This refers to the brain’s ability to change and reorganize its neural networks. And it includes in some areas impacted by various mental health conditions, such as depression.”
Unfortunately, at this time, this kind of treatment does not have FDA approval.
Where Did The Drug Come From?
Ketamine originates from phencyclidine, an anesthetic with previous use on animals in a veterinary setting.
In 1956, the Parke Davis Company stumbled upon ketamine. The drug baffled scientists due to its ability to create drunkenness in rodents, delirium in dogs, trance-like states in pigeons, and anesthesia in monkeys.
Andrea Hanson, licensed and trained psychedelic-assist therapist explains.
“It was decidedly safe to use as an anesthetic for humans, however humans expressed experiencing a state coined as ‘emergence delirium,’ which was considered undesirable and typically suppressed with some sort of benzo like Xanax,” she says. “The psychology field, however, that was in somewhat of a psychedelic renaissance found the emergence delirium intriguing and began to experiment with it alongside LSD, MDMA and Psilocybin.”
How Do You Make Ketamine?
Since ketamine is an abusable drug, it is difficult, if not near-impossible, to find step-by-step instructions on how to make it. However, Hanson explains the scientific explanation for its creation.
“Ketamine is synthesized when 2-chlorobenzonitrile is reacted with the Grignard reagent cyclopentylmagnesium bromide before it is brominated using bromine to form bromoketone,” she says. “Next, it reacts with methylamine in an aqueous solution with hydrolysis of the tertiary bromine atom. Finally, the heat from decalin causes a ring-expansion rearrangement. The result is ketamine.”
Slightly confusing, yes. But, only a chemist or a pharmacist should make ketamine.
Modern-Day Uses For Ketamine
Ketamine on the battlefield during wartime as an anesthetic and hallucinogenic is common. Throughout history, it’s been exponentially helpful in alleviating the mental, physical and emotional pain of soldiers with wartime injuries.
“When soldiers sustain injuries in battle and need to be life-flighted to a doctor, a ketamine injection occurs,” explains Hanson. “Statistically, soldiers are far more likely to survive the flight when given ketamine.”
In a clinical setting, ketamine’s history traces back decades. Surgeries and dental procedures on adults, children, animals and the elderly use it as an anesthetic.
“Because of ketamine’s unique properties, it doesn’t come with the same risks as other anesthetic medications used in surgeries,” says Hanson. “While other anesthetics slow down heart and breath rate, ketamine increases them. This gives it a uniquely safe profile.”
A more recent use of ketamine is its use as a therapeutic catalyst for treating several mental health conditions. This includes trauma, depression, addiction, and both chronic and acute suicidality in individuals, couples and group-therapy settings.
When using as a treatment method, ketamine comes in smaller doses than when its use is as an anesthetic drug.
“Ketamine in combination with expert therapeutic care is three times as effective as leading antidepressants and offers immediate relief from symptoms rather than the 3-4 weeks typical of other psychiatric medications,” Hanson says.
Comparing Ketamine To Antidepressants
“While psychiatric medications kill more people per year than heroine overdoses per year, there are zero deaths from ketamine in therapeutic settings.”
Ketamine also has uses with inflammation. As an immunomodulatory drug, it locally interferes with the determinants of primary immunity. This prevents the spread of local inflammation without delaying inflammatory resolution, according to Dr. Byakodi.
When To Expect Its Effects
How long it takes to start feeling the effects of ketamine relates to the administering technique. When it goes intravenously through an IV, it comes within seconds. If it comes via a shot in the muscle, the effects come within minutes. When a person is using it via a nasal spray, the impact happens within seconds.
If consuming orally, the feeling of ketamine comes later on — typically around 15-20 minutes, according to Hanson.
“Therapeutic effects come in stages and are dependent on the therapeutic support prior to the ketamine administration,” she says. “Elation and peace often come while in the peak ‘high,’” she says. “Suicidality, stress, anger, resentment, and distress are greatly reduced or completely gone.”
When treating depression, anxiety and trauma, the psychedelic effects of ketamine arrive within five minutes via injection. Likewise, the same timeframe comes via oral use. This is according to Michael Dow, Psy.D., psychotherapist and author of The Brain Fog Fix with Field Trip Health.
“Other mood-boosting effects usually come within 4-24 hours of administration, during which the majority of patients with suicidal thoughts notice a significant decrease of symptoms,” he says.
“In mental health, this rapid relief is a game-changing benefit when it comes to severe mental illness. Traditional talk therapy and prescription antidepressants usually take weeks to begin working.”
Best Practices For Taking Ketamine
Research supports the notion that ketamine is best with an assistant for a therapeutic process, not a stand-alone treatment. This is why Hanson warns against going to a doctor’s office which offers stand-alone ketamine treatments.
“At worst, you’ll have a terrible, scary dissociated experience with random noises in a sterile, clinical setting. At best, you’ll get high for about an hour and feel a little elated for about a week,” she says.
When seeking ketamine treatment, Hanson recommends looking for a clinic that specializes in psychedelic assisted breakthroughs. These kinds of facilities know how to set the mood for a psychedelic experience versus a medically sedated one. They are often comfortable, have ambient lighting, provide pillows and light music, and are free of interruptive noises.
“The ketamine session should last four hours minimum with therapeutic work before administration.”
“Therapeutic presence and some direction if needed or asked for during the peak experience, particularly at the lowest doses. Lastly, therapeutic intervention comes as the ketamine is wearing off and glutamate levels are high,” Hanson says.
No matter where you are getting your ketamine therapy, supervision of a healthcare provider is a must. An important note: Ketamine may not work for everyone, and there may be medical contraindications to its use.
“This is why safe protocols help screen for patients who are likely to benefit, and avoid using ketamine in those who are unlikely to benefit or may have contraindications to its safe use,” adds Dr. Flanders.
How Much Does A Ketamine Infusion Cost?
A ketamine infusion cost can be pricey, ranging from $500 to $3000 per session.
However, Hanson points out that the cost of not doing it can be significant lower than alternative treatments.
“One client of mine made more progress in one week than in the two years they spent at an inpatient facility costing over $250,000. While another made more progress in one session than they had in 20 years of weekly therapy,” she says. “The upfront cost is worth the rapid, long-lasting results achieved in the right setting with appropriate therapeutic support.”