Ketamine is an NMDA receptor antagonist used as a dissociative anesthetic, sedative, and painkiller. It can also have recreational uses. Substances that may potentiate or interact with ketamine include:
- Benzodiazepines: These sedative drugs can increase the sedation, amnesia, and muscle relaxation effects of ketamine. However, the combination may also increase the risk of respiratory depression and overdose.
- Opioids: Combining ketamine with opioids may intensify the analgesic and sedative effects of both substances, but it can also significantly increase the risk of respiratory depression and overdose.
- Alcohol: Mixing ketamine with alcohol can lead to increased drowsiness, dizziness, and impaired coordination, making it more dangerous to engage in activities that require concentration and motor skills. The combination can also increase the risk of respiratory depression and overdose.
- Cannabis: Some users report that combining ketamine with cannabis can enhance the psychedelic and dissociative effects of ketamine, but this combination might also increase the likelihood of anxiety, paranoia, and other unpleasant side effects.
- Other dissociatives: Combining ketamine with other dissociative drugs, such as DXM or PCP, can lead to more intense and potentially dangerous effects.
- Monoamine oxidase inhibitors (MAOIs): These medications can interact with ketamine and potentially lead to a dangerous increase in blood pressure or other side effects.
- Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs): These antidepressants may interact with ketamine and alter its effects, though the exact nature of this interaction is not well understood.
Depressants:
- Alcohol, benzodiazepines like diazepam, and opioids can enhance the sedating effects of ketamine, increasing risk of respiratory depression and loss of consciousness. [1]
Stimulants:
- Cocaine, amphetamines, and other stimulants may counteract ketamine’s sedative effects, while increasing blood pressure and cardiovascular risks. [2]
Monoamine oxidase inhibitors (MAOIs):
- MAOIs can cause dangerous enhancement of ketamine’s effects on blood pressure. They should not be used together. [3]
Other drugs/supplements:
- Grapefruit juice can inhibit ketamine metabolism, raising its blood levels. [4]
- St John’s Wort may decrease ketamine levels due to interactions in the liver. [5]
[1] https://www.ncbi.nlm.nih.gov/books/NBK482238/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158846/
[3] https://www.tandfonline.com/doi/abs/10.3109/00952991003763143
[4] https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2477
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3569102/