Table of ContentsView AllTable of ContentsDefinitionSymptomsKetamine EffectsHow Does Ketamine Work?Why People Take KetamineKetamine AddictionSigns of OverdoseHow to Get Help
Table of ContentsView All
View All
Table of Contents
Definition
Symptoms
Ketamine Effects
How Does Ketamine Work?
Why People Take Ketamine
Ketamine Addiction
Signs of Overdose
How to Get Help
A “k-hole” is how it feels when you take a high enough dose ofketaminethat both your environmental awareness and bodily control become very impaired. When someone has “fallen into a k-hole” (the slang term for this ketamine effect), they are temporarily unable to interact with others or the world around them.
Ketamine is a dissociative drug, which means that it can make users feel detached from reality and themselves. It was originally used as an anesthetic but has also been found effective for treating major depression and bipolar disorder—under medical supervision.
Learn what a k-hole is and the symptoms people experience in this state. This article also discusses other ketamine effects, how it can be used to treat certain mental health conditions, signs of a ketamine overdose, and how to get help.
Verywell / JR Bee
What Is a K-Hole?
A k-hole is when high doses of ketamine lead to intense feelings ofdissociation. This can cause feelings of being disconnected from your body, or unable to control your own body. It also sometimes affects the ability to speak and move around easily.
One way to think about a k-hole is as a state betweenintoxicationand coma. Some people refer to a k-hole as an out-of-body or near-death experience.
As the consciousness of the real world diminishes, alterations in the senses during a k-hole may lead to illusions andhallucinations. While usually temporary, some people have shown ongoing dissociative and psychotic symptoms with long-term ketamine misuse.
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K-Hole Symptoms
A k-hole can be frightening and induce strong feelings of powerlessness. This may be especially intense if your ability to speak is affected. When in a k-hole, it can be frustrating if someone is trying to communicate with you and you can’t respond.
To others, someone in a k-hole may simply look immobile andintoxicated, although their eyes may move around.This is an effect known asnystagmus. Other k-hole symptoms include marked confusion, unexplainable experiences, floating sensations, and mind/body dissociation.
One of the risks of falling into a k-hole is difficulty coming out of the dissociative state. Some people continue to feel disconnected from the world around them (and from their life), and may even develop ongoing symptoms ofpsychosis.
Ketamine can have effects on the brain, heart, and more. Short-term side effects of taking ketamine can include:
Long-term side effects of taking ketamine frequently and/or at high doses include:
While researchers are still learning more about how ketamine works, some of its effects are believed to stem from blocking glutamate receptors in the brain.Glutamate is one of the most abundant neurotransmitters found in the body that helps regulate important parts of the nervous system.
Overstimulation of the glutamate pathways in the brain may contribute to the onset of depression. Because of this, ketamine has attracted attention as a possible treatment for the condition.
Like other substances, some people use ketamine as a way to cope with distress or as a way to self-treat feelings of depression. Others use ketamine recreationally at dance parties and raves.
However, it is important to only use ketamine under the direction and supervision of the doctor to avoid unwanted short or long-term side effects.
Your doctor can evaluate your symptoms and recommend treatments that will work best for your needs.
Ketamine and Depression
A review of several studies found that ketamine, at the proper dose, is a fast-acting antidepressant, often reaching maximum efficacy at 24 hours.This can appeal to people with depressive symptoms, especially when manyantidepressants take weeks to monthsbefore any changes are noticed.
Treating depression or other psychiatric symptoms with ketamineshould only be done under the supervision of a trained healthcare professional and with a valid prescription such as Spravato, a nasal spray that contains a metabolite of ketamine (esketamine). Ketamine infusion clinics are gaining popularity and provide off-label treatment for treatment-resistant depression, bipolar disorder, anxiety, posttraumatic stress disorder, and obsessive-compulsive disorder.
People tend to develop a tolerance to ketamine quickly, which means it requires more of the substance to produce the same effects. Ketamine can be safe when used as prescribed in clinical settings, but misuse may lead to psychological dependence.
Symptoms of ketamine addiction can include:
People who have a psychological dependence or addiction to ketamine may also find it difficult to function normally in their daily life. It can interfere with important daily tasks including school, work, social relationships, and family life.
What Is Ketamine Addiction?
Signs of Ketamine Overdose
Taking too much ketamine can cause anoverdose. Signs of a ketamine overdose include dangerously slow breathing and loss of consciousness.
Other symptoms of a ketamine overdose can include:
If an overdose is suspected, get immediate medical attention.
There are many safe and effective ways oftreating depressionbesides ketamine. If you have been through significant trauma, such as physical, sexual, or emotional abuse, or if you are struggling with feelings of guilt or emptiness, there are various therapies that can help you.
A mental health professional can help find the best treatment options for you. This might includepsychotherapy, medications, or both. These treatments can help you feel better without having to experience a k-hole or other negative ketamine effects. This can be a very uncomfortable experience for people who don’t like feeling a ‘loss of control.’
If you are experiencing symptoms of ketamine addiction, talk to your doctor about your treatment options. Treatment options often involve therapy and support groups. Types of therapy that may be helpful includecognitive behavioral therapy,group therapy, ormotivational enhancement therapy.
There are no FDA-approved medications to treat ketamine addiction. However, your doctor may prescribe medications to treat symptoms of other conditions you are also experiencing, such as anxiety, depression, or bipolar disorder.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see ourNational Helpline Database.
12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao M, Rejaei D, Liu H.Ketamine use in current clinical practice.Acta Pharmacologica Sinica. 2016;37:865-872. doi:10.1038/aps.2016.5Strous J, Weeland C, van der Draai F, et al.Brain changes associated with long-term ketamine abuse, a systematic review.Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231Zanos P, Moaddel R, Morris PJ, et al.Ketamine and ketamine metabolite pharmacology: Insights into therapeutic mechanisms.Pharmacol Rev. 2018;70(3):621-660. doi:10.1124/pr.117.015198Zuccoli ML, Muscella A, Fucile C, et al.Paliperidone for the treatment of ketamine-induced psychosis: A case report.Int J Psychiatry Med. 2014;48(2):103-108. doi:10.2190/PM.48.2.cU.S. Drug Enforcement Administration.Drug fact sheet: Ketamine.Bell RF, Kalso EA.Ketamine for pain management.Pain Rep. 2018;3(5):e674. doi:10.1097/PR9.0000000000000674Pahlamar JJ, Rutherford C, Keyes KM.Trends in ketamine use, exposures, and seizures in the United States up to 2019.Am J Public Health. 2021;111(11):2046-2049. doi:10.2105/AJPH.2021.306486Zanos P, Gould TD.Mechanisms of ketamine action as an antidepressant.Mol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255U.S. Drug Enforcement Administration.Drug scheduling.Corriger A, Pickering G.Ketamine and depression: A narrative review.Drug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437Fan N, Xu K, Ning Y, et al.Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users.Psychiatry Res. 2016;237:311-5. doi:10.1016/j.psychres.2016.01.023Kalsi SS, Wood DM, Dargan PI.The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use.Emerg Health Threats J. 2011;4:7107. doi:10.3402/ehtj.v4i0.7107
12 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao M, Rejaei D, Liu H.Ketamine use in current clinical practice.Acta Pharmacologica Sinica. 2016;37:865-872. doi:10.1038/aps.2016.5Strous J, Weeland C, van der Draai F, et al.Brain changes associated with long-term ketamine abuse, a systematic review.Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231Zanos P, Moaddel R, Morris PJ, et al.Ketamine and ketamine metabolite pharmacology: Insights into therapeutic mechanisms.Pharmacol Rev. 2018;70(3):621-660. doi:10.1124/pr.117.015198Zuccoli ML, Muscella A, Fucile C, et al.Paliperidone for the treatment of ketamine-induced psychosis: A case report.Int J Psychiatry Med. 2014;48(2):103-108. doi:10.2190/PM.48.2.cU.S. Drug Enforcement Administration.Drug fact sheet: Ketamine.Bell RF, Kalso EA.Ketamine for pain management.Pain Rep. 2018;3(5):e674. doi:10.1097/PR9.0000000000000674Pahlamar JJ, Rutherford C, Keyes KM.Trends in ketamine use, exposures, and seizures in the United States up to 2019.Am J Public Health. 2021;111(11):2046-2049. doi:10.2105/AJPH.2021.306486Zanos P, Gould TD.Mechanisms of ketamine action as an antidepressant.Mol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255U.S. Drug Enforcement Administration.Drug scheduling.Corriger A, Pickering G.Ketamine and depression: A narrative review.Drug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437Fan N, Xu K, Ning Y, et al.Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users.Psychiatry Res. 2016;237:311-5. doi:10.1016/j.psychres.2016.01.023Kalsi SS, Wood DM, Dargan PI.The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use.Emerg Health Threats J. 2011;4:7107. doi:10.3402/ehtj.v4i0.7107
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gao M, Rejaei D, Liu H.Ketamine use in current clinical practice.Acta Pharmacologica Sinica. 2016;37:865-872. doi:10.1038/aps.2016.5Strous J, Weeland C, van der Draai F, et al.Brain changes associated with long-term ketamine abuse, a systematic review.Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231Zanos P, Moaddel R, Morris PJ, et al.Ketamine and ketamine metabolite pharmacology: Insights into therapeutic mechanisms.Pharmacol Rev. 2018;70(3):621-660. doi:10.1124/pr.117.015198Zuccoli ML, Muscella A, Fucile C, et al.Paliperidone for the treatment of ketamine-induced psychosis: A case report.Int J Psychiatry Med. 2014;48(2):103-108. doi:10.2190/PM.48.2.cU.S. Drug Enforcement Administration.Drug fact sheet: Ketamine.Bell RF, Kalso EA.Ketamine for pain management.Pain Rep. 2018;3(5):e674. doi:10.1097/PR9.0000000000000674Pahlamar JJ, Rutherford C, Keyes KM.Trends in ketamine use, exposures, and seizures in the United States up to 2019.Am J Public Health. 2021;111(11):2046-2049. doi:10.2105/AJPH.2021.306486Zanos P, Gould TD.Mechanisms of ketamine action as an antidepressant.Mol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255U.S. Drug Enforcement Administration.Drug scheduling.Corriger A, Pickering G.Ketamine and depression: A narrative review.Drug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437Fan N, Xu K, Ning Y, et al.Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users.Psychiatry Res. 2016;237:311-5. doi:10.1016/j.psychres.2016.01.023Kalsi SS, Wood DM, Dargan PI.The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use.Emerg Health Threats J. 2011;4:7107. doi:10.3402/ehtj.v4i0.7107
Gao M, Rejaei D, Liu H.Ketamine use in current clinical practice.Acta Pharmacologica Sinica. 2016;37:865-872. doi:10.1038/aps.2016.5
Strous J, Weeland C, van der Draai F, et al.Brain changes associated with long-term ketamine abuse, a systematic review.Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231
Zanos P, Moaddel R, Morris PJ, et al.Ketamine and ketamine metabolite pharmacology: Insights into therapeutic mechanisms.Pharmacol Rev. 2018;70(3):621-660. doi:10.1124/pr.117.015198
Zuccoli ML, Muscella A, Fucile C, et al.Paliperidone for the treatment of ketamine-induced psychosis: A case report.Int J Psychiatry Med. 2014;48(2):103-108. doi:10.2190/PM.48.2.c
U.S. Drug Enforcement Administration.Drug fact sheet: Ketamine.
Bell RF, Kalso EA.Ketamine for pain management.Pain Rep. 2018;3(5):e674. doi:10.1097/PR9.0000000000000674
Pahlamar JJ, Rutherford C, Keyes KM.Trends in ketamine use, exposures, and seizures in the United States up to 2019.Am J Public Health. 2021;111(11):2046-2049. doi:10.2105/AJPH.2021.306486
Zanos P, Gould TD.Mechanisms of ketamine action as an antidepressant.Mol Psychiatry. 2018;23(4):801-811. doi:10.1038/mp.2017.255
U.S. Drug Enforcement Administration.Drug scheduling.
Corriger A, Pickering G.Ketamine and depression: A narrative review.Drug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437
Fan N, Xu K, Ning Y, et al.Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users.Psychiatry Res. 2016;237:311-5. doi:10.1016/j.psychres.2016.01.023
Kalsi SS, Wood DM, Dargan PI.The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use.Emerg Health Threats J. 2011;4:7107. doi:10.3402/ehtj.v4i0.7107
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