Ketamine Harm Reduction
Ketamine prescribed off label is a legal possibility for some use cases. Your medical provider and pharmacist will discuss the various indications and risks involved. Talk to your independent medical provider to see if you might be a candidate for this medicine in conjunction with psychotherapy
Safety and efficacy of ketamine for a number of indications have been studied since 1962, however ketamine is only FDA-approved as a dissociative anesthetic and sedative. The FDA approved half of the molecule of ketamine, esketamine, for Treatment Resistant Depression with and without suicidality.
Ketamine prescribed off label is a legal possibility for some use cases, and your medical provider and pharmacist will discuss the various indications and risks involved in various doses and routes of administration.
Talk to your independent medical provider to see if you might be a candidate for this medicine in conjunction with cognitive behavioral therapy. Your medical provider will discuss other treatment approaches and options as indicated by ongoing, rigorous study.
Medically reviewed
National Institute on Drug Abuse
On Ketamine Bladder Risks
(Formatting edits incoming)
Hannelore Findeis
"The results indicate that the use of single or repeated doses of esketamine at 0.25–0.5 mg/kg is unlikely to cause urothelial toxicity."
https://www.psychiatrist.com/jcp/depression/oral-ketamine-for-depression-practical-considerations/
"There were no cases of bladder toxicity."
https://link.springer.com/article/10.1007/s00213-020-05611-y#Sec11
"It should be noted that recreational ketamine consumption tends to be several orders of magnitude higher (one survey reported 34% of users reported use of 1 g or more in a typical session(Winstock et al., 2012)) than the doses prescribed in the clinical setting for depression. Although adverse effects of long-term ketamine use on the bladder would not necessarily be expected with the therapeutic dosing and frequency used in the treatment of depression, the lack of assessment of urinary symptoms has been another limitation in RCTs of ketamine (Short et al., 2018)."
https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1022.6283&rep=rep1&type=pdf
"Additionally, concerns have been raised about the possible incidence of bladder toxicity with repeated ketamine use (Middela, 2011). Only future clinical research can establish whether maintenance ketamine infusions represent a safe and effective option for initial ketamine responders."
https://www.tandfonline.com/doi/pdf/10.1080/00952990.2020.1769118
"Scientific data show that, in a clinical setting, the applied doses of ketamine are well-tolerated by humans and its negative effects are manageable. These effects seem to be dose and frequency-related, which is strongly supported by the scientific literature and by the analyzed threads, where the adverse effects of ketamine were mentioned as mild and manageable."
https://core.ac.uk/download/pdf/161939325.pdf
"The most serious of these side effects is ketamine-induced ulcerative cystitis or ‘ketamine bladder’. This is a recently identified condition characterised by extremely painful and frequent urination that seems to have severe and potentially long lasting impacts on the patient. However, drug users who take ketamine less than daily have not reported, and show no evidence of ‘ketamine bladder’.
Self Management and Recovery Training (SMART)
SMART Recovery was established in 1994 to meet the increasing demand of those seeking a secular and evidence-informed alternative to the widespread 12-Step addiction recovery program based on cognitive behavioral therapy. SMART Recovery also trains facilitators and mental health providers and allied fields.
SMART Recovery picks up with at home and community resources where cognitive behavioral therapy leaves off, especially for people dealing with problematic behaviors like substance dependence. Building this resource into the treatment plan offers another safeguard against the misuse of medicines, or other compulsive types of cravings and behaviors that end with personal and/or social harm. They offer great tools, regular meetings around the world and online.
