Ketamine is a classical dissociative substance of the arylcyclohexylamine class. Originally used as a surgical anesthetic but after becoming popular recreationally it is now used for its potential to relieve treatment-resistant depression. Effects of Ketamine are highly dose dependent. Subjective effects submitted by users report Ketamine at lower doses causes alcohol-like disinhibition and relaxing effects. At high doses Ketamine causes effects including motor control loss, hallucinations, memory suppression, dissociation and potentially “out-of-body” experiences.

1. Dose

• Therapeutic Dosage: Nasal spray ketamine is typically given in a specific dose based on the patient’s needs and response, often as one to two sprays per nostril. Sessions are usually scheduled once or twice weekly, depending on therapeutic goals.
• Controlled Administration: The dose is typically pre-measured and adjusted gradually to maintain effectiveness and minimize side effects.

2. Preparation

• Hydration and Nutrition: Patients are encouraged to stay hydrated and avoid heavy meals immediately before the session, as ketamine can sometimes cause mild nausea.
• • Calm Environment: A relaxed, quiet environment in the clinic or treatment center supports a comfortable and therapeutic experience.

3. During Use

• Professional Supervision: Patients remain under observation during the session, with healthcare providers monitoring vital signs and response to ensure safety.
• Minimal Stimulation: Keeping lights dim and avoiding loud sounds helps create a calm atmosphere, allowing the patient to engage fully in the experience.

4. Post-Use Care

• • Rest and Recovery: Patients may feel mild dizziness, fatigue, or sensory sensitivity after the session, so post-session rest and hydration are recommended.
  • Therapeutic Integration: Follow-up sessions with a therapist can help patients process the experience and integrate any insights, enhancing the long-term benefits of the treatment.

The effects of nasal spray ketamine generally last between 45 minutes to 2 hours, depending on dosage and individual metabolism. Here’s a breakdown:

1. Onset (5-15 minutes): The effects begin quickly as the ketamine is absorbed through the nasal passages. Patients often feel a sense of calm and initial relief from anxiety or depressive thoughts.
2. Peak Effects (30-60 minutes): During the peak phase, patients experience increased relaxation, introspection, and sometimes mild dissociation. This phase is generally less intense compared to IV or IM ketamine, making it easier to stay aware and grounded.
3. Comedown (30-60 minutes): As the effects begin to wear off, patients return to their baseline state, often with a lingering sense of calm or emotional clarity.
4. Aftereffects (up to 24 hours): Many patients report feeling emotionally lighter, more relaxed, and with improved mood for days or even weeks, depending on their unique response and therapy regimen.