Regardless of the answer to the question posed here keep in mind that high powered psychiatric interventions can be very effective, even if they don't last forever. Whether it's ketamine or electroconvulsive therapy - it's certainly better than suicide. At least promise yourself to try such things first (in a hospital setting! yes they have those in hospitals in developed countries) before you make the conclusion that your life has become too painful to live it.<p>PS. there are many other treatments that doctors may give you before reaching for the big guns; those can be very effective too.
> However, the average ketamine “user” consumes 500-1000mg of ketamine per day<p>This is an outrageous claim with no citation. I'm a regular user, and this is roughly what I consume per month, if I'm going hard
It's also worth noting that ketamine does appear to increase neural plasticity and can promote the formation of new synaptic connections (synaptogenesis), particularly in areas of the brain involved in mood regulation.<p>That being said, I too have experienced tolerance with ketamine infusions- even with a month between doses. Always found it a bit troubling and I'd rather not have to continue to increase the dose.
Although everything seems to be researched thoroughly there are many mistakes. Mistakes that are pretty basic (like Venlafaxine having it's origin in an amphetamin instead of tramadol) and lead me to the assumption of sloppy work. In addition study results are stated as facts whereas reproducibility is very poor in psychiatry.<p>In addition microdosing escitalopram at like 2,5mg/d seems like it is mostly placebo. When introducing a drug there are dose response studies done, that determined that ESC needs 10mg for most people to be effective against depression. Same with 2,5% of the starter selegiline dose.<p>I think the texts of this author need to be viewed with much caution.
> However, the average ketamine “user” consumes 500-1000mg of ketamine per day, which is 100-300x as much as therapeutic use (0.5mg/kg)<p>For users weighing one kilo. For users of a more normal weight, you’re off by an order of magnitude.
I'm finding this draft article pretty confusing, and am not sure why it's shared in its current state. I think it should also cite sources.<p>> "However, the average ketamine “user” consumes 500-1000mg<p>My impression was that the majority who try ketamine do it a handful of times in their whole lives, usually <200mg.
For anyone interested in the therapeutic (or otherwise) use of ketamine, I strongly recommend the autobiography of John Lilly, the neuroscientist who developed the sensory deprivation tank. His discussion of ketamine-aided spiritual entity discovery and dolphin communication are enlightening.<p><a href="https://archive.org/details/scientistnovelau00lill/page/n5/mode/2up" rel="nofollow">https://archive.org/details/scientistnovelau00lill/page/n5/m...</a>
I spent some time around a ketamine abuser and it was shocking how he seemed like… at one point he was a very capable and knowledgeable person and how much was just gone.
Reading through the article and comments, it seems like there's a lot of confusion about what is considered "a user" and what typical dosages are. Obviously, a rave fiend who used to do MDMA twice a week and coke at least 5 and then moved to K would consume, completely disregarding this health but still staying conscious enough to continue dancing on a dance floor. At the same time, a tech worker who does Yoga, goes to Burning Man every year and have a long and productive relationship with psychedelics probably does a very K every 1-2 years in the right set and setting, but consumes a dose high enough to venture deep into the K-hole to seek some mystical answers — just as he does the same with DMT and other exotic Shulgin creations.<p>From the anecdotal data (including the tragic suicide note that pops up on HN every now and then) and sporadical research, it's very unclear how much danger does the second scenario actually entail.
> Nonetheless, it’s widely recognized that individuals who occasionally use ketamine find they need significantly higher doses than when they first started, even after prolonged periods of abstinence.<p>Sorry for the slight divergence from the focus on ketamine, but more generally, does anyone know if this applies to other medications that alter the brain's function?<p>I've noticed the same phenomenon with the adderall I am prescribed for ADHD, and despite the tolerance buildup and the offer from my psychiatrist, I refuse to bump up the dose further due to fears of long-term changes in the brain. Honestly, I'm considering ditching it altogether after about a decade of prescription because I become more paranoid over time about unknown, long-term effects. Posts like this about ketamine don't help my suspicions.
> Ketamine abuse is well known to cause widespread cognitive and neurological impairment. However, the average ketamine “user” consumes 500-1000mg of ketamine per day, which is a lot more than therapeutic use (0.5mg/kg). One glass of wine per week is surely different from a gallon of vodka per day.<p>Author is mistakenly comparing oral vs. IV routes. Of course the amounts are different because metabolism is different. How can they pontificate and make such a mistake?
All drugs build up resistance, making a increasging of dosage necessary, and dosage maketh the poison.<p>You might start out with a PTSD-tracking app, pumping a microdose of Keta via a insulin-pump every time the eldritch horror of reality hits you again and again, but you will still need to crash out of it regularly ever n months.<p>Its a high-functioning half-life, but preferable to the alternatives?
Regarding lesions, a recent pair of articles about Ibogaine.<p><a href="https://pubmed.ncbi.nlm.nih.gov/39981248/" rel="nofollow">https://pubmed.ncbi.nlm.nih.gov/39981248/</a><p><a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11303312/" rel="nofollow">https://pmc.ncbi.nlm.nih.gov/articles/PMC11303312/</a>
Ketamine taken under the supervision of a physician is an effective treatment. I have seen its effects with my own eyes.<p>Do not fuck around with street drugs. If the FDA didn't approve it, there could be anything in it.
Everything acting on the brain is neurotoxic at sufficient doses. However, I would be far more worried about cardiovascular effects, for which life threatening complications are much more immediate.
I can recommend everyone to read Felix Hill's suicide note on the topic. He was a scientist in DeepMind: <a href="https://docs.google.com/document/d/1-jBoSEVlryiX1IaSzV4vKuihDfm_LgXUznvSpl1T1kg/mobilebasic" rel="nofollow">https://docs.google.com/document/d/1-jBoSEVlryiX1IaSzV4vKuih...</a>
It is not neurotoxic, in fact, it is the opposite due to it being an NMDA receptor agonist (neuroplasticity). I thought we have known this for a long time. It could be, in very high doses. Just like you can die from water intoxication too.