Ketamine has a firm place in anaesthesia and in treatment-resistant depression — there with controlled dosing, monitoring and clearly defined treatment intervals.
In recreational use, a different risk profile emerges:
Acute complications:
- K-hole: dissociative state, inability to move, dangerous in an uncontrolled environment (falls, aspiration)
- Mixing with GHB, alcohol or benzos multiplies the risk of respiratory depression
- Fall injuries from balance problems — stairs, pools, sharp furniture
Chronic complications (long-term use):
- Ketamine-induced cystitis: inflammation and shrinkage of the bladder. Symptoms: frequent urination, pain, bloody urine. In late stages, surgery is required.
- Ketamine-induced cholangiopathy: liver strain, bile duct complications
- Cognitive deficits — memory, concentration, depressive episodes
- Tolerance and dependence: rapid development, harsh withdrawal
With recurring symptoms like bladder pain, frequent urination or bloody urine: take a break, get a medical check-up. Early stages are partially reversible.