Ketamine often carries a reputation for being associated with party settings, and some associate it solely with veterinary use, nicknaming it a “horse tranquilizer”.
Although ketamine has been used in veterinary practices to sedate large animals like horses, its medical use in humans goes back to the 1960s. And more recently, it shows high rates of effectiveness in treating chronic mental health challenges such as treatment-resistant depression, OCD, anxiety, and complex trauma.
Read on to clear up misconceptions about ketamine, understanding its origins and potential uses for advanced mental health treatments.
What is Ketamine?
Ketamine is a dissociative anesthetic medication primarily acting as an NMDA receptor antagonist to induce anesthesia and analgesia. In small doses, it causes hallucinogenic, dissociative effects, and has been found to relieve symptoms of chronic depression.
Ketamine works by blocking NMDA receptors on specific brain cells, especially in regions such as the prefrontal cortex (PFC), acting as a “brake” on brain activity. This triggers a surge of glutamate that floods pathways in the PFC and hippocampus [1].
This mechanism is thought to help rebuild weakened neural connections and brain circuits related to fear, mood, and memory. Studies show that ketamine therapy works in 60 to 70% of people not responsive to typical SSRI antidepressants [1].
Is Ketamine Legal?
Ketamine is a Schedule III controlled substance under the FDA. It is illegal to distribute or use recreationally, but it is legal when used in medical settings such as hospitals, psychiatric facilities, or licensed ketamine clinics. It was FDA-approved in 2019 for treatment-resistant depression and is also used off-label for conditions such as OCD, trauma, and anxiety [2].
The Origins of Ketamine: Was It Really Used on Horses?
Ketamine was not “originally designed or created for horses”. It was synthesized in 1962 by Calvin Stevens as a safer anesthetic alternative to phencyclidine (PCP), which had been developed for human surgical anesthesia but caused severe hallucinations and side effects.
It received FDA approval for human anesthesia in 1970. It was increasingly used in battlefield surgery during the Vietnam War, and it wasn’t until later that it found its way into veterinary applications for horses and other animals [3].
Veterinary Applications of Ketamine
Ketamine is used as a dissociative anesthetic in veterinary practice across large animal species such as horses, cattle, and camels, and sometimes in dogs or cats. It’s used for procedures requiring sedation, anesthesia induction, and pain management.
In horses, it is commonly used for field anesthesia during castrations and surgeries at 2.2-5 mg/kg (for a 1,100 to 2,200-pound horse, this totals about 2,200-10,000 mg, often combined with xylazine or diazepam for sedation) [4].
Key Differences in Human vs Horse Use of Ketamine
Dosage: Humans receive extremely small, sub-anesthetic doses compared to much higher doses than horses or other large livestock.
Purpose: In horses, ketamine induces deep dissociative anesthesia for major procedures in non-clinic settings. Human applications focus on short surgical anesthesia, pain management, or sub-anesthetic infusions for depression, with stricter monitoring.
Metabolism: Horses metabolize ketamine quickly and at higher doses without toxicity. Humans require close supervision to minimize hallucinations or cardiovascular effects. Horses often need repeat doses for maintenance, unlike controlled human protocols [5].
Is Ketamine Safe for People?
Ketamine is considered safe for people when used under medical supervision. Originally developed and FDA-approved as a human anesthetic, ketamine now holds additional FDA approval for treating major depressive disorder in its nasal spray form, Esketamine.
Off-label, the clinical use of ketamine has grown not only for depression but for other mental health conditions as well, such as anxiety, OCD, and trauma disorders. Recreational use of ketamine can be dangerous and increase the risk of psychosis, cardiovascular distress, and labored breathing.
Common Myths About Ketamine
- Ketamine is only a recreational “party drug” or “horse tranquilizer.” In reality, ketamine is an FDA-approved anesthetic used in human surgery and for conditions like depression. It is also used safely, off-label, and under clinical supervision for conditions like OCD and PTSD in controlled settings.
- Ketamine is highly addictive. While recreational misuse carries risks, medical ketamine therapy uses low, supervised doses that minimize dependence potential.
- Ketamine is a “magic bullet” cure for depression. It offers rapid relief for treatment-resistant cases but works best alongside therapy, lifestyle changes, and ongoing maintenance.
- Ketamine therapy is unsafe or dangerous. When administered by professionals, it has a low risk of serious side effects and is endorsed by organizations like the WHO.
Human Medical Uses of Ketamine
In hospitals, ketamine helps with pain management, emergency procedures, and anesthesia. More recently, it has grown into an advanced mental health treatment, offering hope to those with [2][3][6]:
- Treatment-Resistant Depression: Multiple studies have shown that ketamine can produce rapid antidepressant effects within hours, even in patients who have not responded to traditional antidepressants.
- Suicidal Ideation: Ketamine has shown the ability to quickly reduce suicidal thoughts in emergency and clinical settings, providing new interventions for individuals at immediate risk.
- PTSD and Complex Trauma: Emerging research indicates that ketamine may help alleviate symptoms of PTSD by disrupting the neural pathways involved in trauma-related emotional processing
- Anxiety Disorders: Although still under investigation, some clinical trials suggest that ketamine can reduce severe anxiety symptoms by modulating glutamate neurotransmission, which plays a key role in stress regulation.
- Bipolar Disorder: Ketamine has shown promise in reducing depressive symptoms associated with bipolar disorder, especially in patients unresponsive to standard treatments.
Evidence-Based Ketamine Therapy at Maple Mountain
At Maple Mountain Mental Health and Wellness, our compassionate team of clinical psychiatrists and experienced therapists provides evidence-based, FDA-approved ketamine therapy. Our licensed medical team prioritizes your well-being and safety throughout the entire process.
Through a holistic, blended approach, we address each aspect of your health and recovery needs to support long-term healing. Reach out to see if you are a good candidate for ketamine therapy today. Contact our admissions team!
Sources
[1] Villevieille, T. et al. (2013). Ketamine pharmacology: an update (pharmacodynamics and molecular aspects, recent findings). CNS neuroscience & therapeutics, 19(6), 370–380.
[2]Grinspoon, P. 2024. Ketamine for treatment-resistant depression: When and where is it safe?
[3] Vlisides, E. et al. (2016). Ketamine: 50 Years of Modulating the Mind. Frontiers in human neuroscience, 10, 612.
[4] Clutton, E. et al. (2019). A comparison of two ketamine doses for field anaesthesia in horses undergoing castration. Equine veterinary journal, 51(4), 458–463.
[5] Hubbell, J. et al. 2024. A review of equine anesthetic induction: Are all equine anesthetic inductions “crash” inductions?Journal of Equine Veterinary Science.
[6] Uchida, R. et al. (2024). Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder – A Systematic Review and Meta-Analysis. Clinical neuropsychiatry, 21(1), 22–31.
