When ketamine is administered in a clinical setting, it’s typically given intravenously or intramuscularly. Oral administration is less common because ketamine has a low bioavailability when taken by mouth, meaning that less drug reaches the bloodstream to have an effect. This is due to first-pass metabolism, where the drug is metabolized in the liver before it reaches systemic circulation.
When ketamine is swallowed, it undergoes first-pass metabolism in the liver, converting it into norketamine by the enzyme CYP3A4. Norketamine is less potent than ketamine but still has some psychoactive properties. However, the overall effect is less intense and longer in duration compared to other routes of administration.
Spitting out ketamine, however, would prevent the drug from being metabolically processed similarly. If ketamine is held in the mouth and then spit out, it could be absorbed through the mucous membranes in the mouth and bypass the first-pass metabolism, leading to a more potent effect. However, this is not a common or recommended method of administration, and it’s unlikely to be used in a therapeutic context.
In a therapeutic setting, the goal is to control the dose and effects of the drug carefully. This is best achieved through intravenous or intramuscular administration, where the dose can be carefully measured, and the effects can be monitored and adjusted as necessary. Oral administration is less predictable and can lead to a wider range of effects, which may not be desirable in a therapeutic context.
It’s also important to note that ketamine can have serious side effects, including hallucinations, confusion, and changes in heart rate and blood pressure. These effects can be more pronounced and harder to control with oral administration or other non-standard routes of administration. Therefore, it’s crucial only to use ketamine under the supervision of a healthcare professional.
Lastly, it’s worth mentioning that the misuse of ketamine can lead to dependence and other health problems. If you or someone else is considering using ketamine for therapeutic purposes, it’s important to discuss this with a healthcare provider to understand the potential risks and benefits.
Domino, EF. (2010). Taming the Ketamine Tiger. Anesthesiology: The Journal of the American Society of Anesthesiologists, 113(3), 678-684. This article provides a comprehensive overview of the pharmacology of ketamine.
Zanos, P., Moaddel, R., Morris, P. J., Riggs, L. M., Highland, J. N., Georgiou, P., … & Zarate, C. A. (2018). Ketamine and ketamine metabolite pharmacology: insights into therapeutic mechanisms. Pharmacological reviews, 70(3), 621-660. This review discusses the pharmacology of ketamine and its metabolites, including their effects on the brain and body.
Li, L., Vlisides, P. E. (2016). Ketamine: 50 Years of Modulating the Mind. Frontiers in Human Neuroscience, 10, 612. This article provides a historical perspective on the use of ketamine in medicine and research, including its effects and mechanisms of action.
Morgan, C. J., Curran, H. V. (2012). Ketamine use: a review. Addiction, 107(1), 27-38. This review discusses the use of ketamine, including its effects, potential harms, and the implications for policy and practice.