Variable Experience

The subjective experience of a therapeutic ketamine session can be highly variable, even when the dose is kept constant, due to a combination of factors:

  1. Individual metabolism and pharmacokinetics: People have unique metabolic profiles and rates of drug metabolism, which can affect how their bodies process ketamine. The rate at which the body absorbs, distributes, metabolizes, and eliminates ketamine can differ significantly between individuals. These variations can lead to differences in onset, duration, and intensity of the experience.
  2. Tolerance: Prior exposure to ketamine or other NMDA receptor antagonists may lead to an increase in tolerance. As a result, individuals with higher tolerance levels may require a larger dose to achieve the same effects compared to those with lower tolerance.
  3. Genetic factors: Genetic differences between individuals can influence the way they respond to ketamine. Variations in genes related to the NMDA receptor, as well as other neurotransmitter systems, may contribute to the differences in subjective experiences.
  4. Psychological factors: A person’s mental and emotional state can play a significant role in shaping their experience during a ketamine session. Anxiety, stress, or other pre-existing psychological conditions may affect how one perceives and responds to the effects of ketamine.
  5. Set and setting: The environment and context in which the ketamine session takes place can have a considerable impact on the subjective experience. Factors such as the level of comfort, familiarity, and safety in the environment, the presence of a supportive therapist or guide, and the patient’s mindset can all influence the overall experience.
  6. Expectations: A person’s expectations about the effects of ketamine and the potential therapeutic outcomes can also shape their experience. The placebo effect and the patient’s beliefs about the treatment may contribute to the variability in subjective experiences.

In summary, the subjective experience of a therapeutic ketamine session can be highly variable due to a combination of factors, including individual metabolism, tolerance, genetic factors, psychological state, set and setting, and expectations.

Duman, R. S., Aghajanian, G. K., Sanacora, G., & Krystal, J. H. (2016). Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nature Medicine, 22(3), 238-249.

Krystal, J. H., Sanacora, G., & Duman, R. S. (2013). Rapid-acting glutamatergic antidepressants: the path to ketamine and beyond. Biological Psychiatry, 73(12), 1133-1141.

Luckenbaugh, D. A., Niciu, M. J., Ionescu, D. F., Nolan, N. M., Richards, E. M., Brutsche, N. E., … & Zarate, C. A. (2014). Do the dissociative side effects of ketamine mediate its antidepressant effects? Journal of Affective Disorders, 159, 56-61.

Short, B., Fong, J., Galvez, V., Shelker, W., & Loo, C. K. (2018). Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry, 5(1), 65-78.

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