You will be asked to lie still during the ketamine administration because your sense of balance and coordination will be adversely affected until the drug's effect has worn off-generally two and up to four hours after taking the lozenge. Other possibilities for adverse effects include blurred and uncomfortable vision (you are advised to keep your eyes closed until the main effects have worn off), slurred speech, mental confusion, excitability, diminished ability to see things that are actually present, diminished ability to hear or to feel objects accurately, including one's own body, anxiety, nausea and vomiting. Visual, tactile and auditory processing are affected by the drug. Familiar music may appear quite different to you, even unrecognizable. Synesthesia, a mingling of the senses, may occur. Ordinary sense of time may morph into time dilation.
Because of the risk of nausea and vomiting, please refrain from eating and drinking for at least the 6 hours preceding the session. On the day of treatment, if you eat prior to the 6-hour fasting period, eat lightly. Hydrate well prior to the 6-hour fasting period.
If you are unduly nauseated, you may be offered an anti-nausea medication, odansetron, orally.
Ketamine generally causes a significant increase in blood pressure but ususally not pulse rate. If blood pressure monitoring reveals that your blood pressure is too high, you may be offered clonidine to remedy this.
Agitation may occur during the course of a ketamine session. If your agitation is severe, you may be offered lorazepam or herbal anti-anxiety medications to help you relax.
The administration of ketamine may also cause the following adverse reactions: tachycardia (elevation of pulse), diplopia (double vision), nystagmus (rapid eye movements), elevation of intraocular pressure (feeling of pressure in the eyes), and anorexia (loss of appetite). The above reactions occurred after rapid intravenous administration of ketamine or intramuscular administration of high doses of ketamine (in a range of greater than 5 mg/kg used for a surgical anesthesia. The dose to be used in this sub-anesthetic ketamine therapy is much lower (2 mg/kg or less).
Driving an automobile or engaging in hazardous activities should not be undertaken for 3 hours after treatment with ketamine and definitively until all effects have stopped if for any reason they continue longer.
In terms of psychological risk, ketamine has been shown to worsen certain psychotic symptoms in people who suffer from Schizophrenia or other serious Mental Disorders. It may also worsen underlying psychological problems in people with severe Personality Disorders. If you have been or are presently diagnosed with similar severe Mental Disorders, you may not be a candidate for ketamine therapy.
During the experience itself, some people have reported frightening, unusual experiences. These frightening experiences, however, may be of paramount value to your transition to recovery from the suffering that brought you to your ketamine work. You will receive support help and ongoing guidance from your therapist.