KETAMINE | KET | SPECIAL K

The potential for ketamine to be used as a psychedelic in the treatment of psychiatric disorders was first noted in the 1970s and has been the focus of clinical research for mental health conditions since the 1990s. Scientists explored the use of ketamine at various sites including the Maryland Psychiatric Research Institute (Wolfson, 2016) and in Russia in the treatment of alcoholism and heroin misuse (Krupitsky, 1994). To curb its illicit, recreational use, the United States placed ketamine into the Schedule III federally controlled category in 1999, however, clinical research continued steadily, and picked up pace in the early 2000s, particularly as it became clear that he rapid, profound, and sustainable antidepressant effects of ketamine seem poised to transform the treatment of depression.

Over the last two decades, there has been growing interest among the clinical community in the use of ketamine in the treatment of a variety of psychiatric indications. In the early 2000s, several clinical trials reported the rapid antidepressant properties of ketamine (Berman et al., 2000; Zarate et al., 2006). In March 2019, the FDA approved esketamine (one of two molecular structures of ketamine that are ‘mirror’ images, or enantiomers) for the treatment of treatment-resistant depression. The robust antidepressant effects of ketamine are among the most important discoveries in mood disorders research over the last half century. This empirical literature provides strong evidence for ketamine as an effective treatment for rapid reduction of depression and suicidality and is showing potential as a treatment for other conditions including anxiety disorders, SUDs, and PTSD.

A research paper by WHRIN and Talking Drugs 20 June 2024 identified these gender considerations:

Human Studies:

• Women report more discontinuation symptoms like anxiety and urinary issues than men.
• Women experience higher risks of hypertension with ketamine.
• Women have a faster clearance rate of ketamine but also experience greater analgesic effects than men.

Rodent Studies:

• Female rats show anxiety and depressive behaviours with chronic ketamine use, which can be reversed by hormone changes.
• Hormones like estrogen and progesterone significantly influence ketamine's effects, suggesting menstrual cycle phases may affect sensitivity.

Opioid pathways:

• Differences in how ketamine interacts with opioid pathways in males and females.
• Females might compensate for blocked opioid receptors by growing more receptors, influenced by testosterone.
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Antidespressant effects:

• Women are more sensitive to lower doses for antidepressant effects, with faster dissipation of effects.
• There's a gap in research on sex differences in ketamine's long-term antidepressant effects.
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• Limited data on ketamine use during pregnancy and breastfeeding.
• Small studies indicate ketamine might be safe for breastfeeding but should be monitored for infant sedation.

• Ketamine's dissociative effects can increase risks of accidents, sexual assault, and unprotected sex.
• Gender-diverse people face heightened risks of violence and exploitation, necessitating tailored harm reduction strategies.