Ketamine: A Real Psychedelic
It has become increasingly popular for folks in the psychedelic space to suggest that ketamine should not be classified as a psychedelic. This assertion echoes a troubling trend within the psychedelic community: drug exceptionalism. By drawing rigid boundaries around what constitutes a "true" psychedelic, we risk dismissing valuable tools that could aid countless individuals in need. Ketamine, often marginalized in such discussions, deserves to be reconsidered as not only a psychedelic but also a vital option in psychedelic-assisted therapy.
The term "psychedelic" originates from the Greek words psyche (soul) and deloun (to manifest), meaning "mind-manifesting." Ketamine, like classic psychedelics such as psilocybin and LSD, can profoundly alter consciousness, facilitating shifts in perception, emotion, and cognition. At higher doses, ketamine induces dissociative states that provide access to non-ordinary states of consciousness, often characterized by feelings of unity, transcendence, and insight—hallmarks of the psychedelic experience.
Critics might point out that ketamine operates through an entirely different mechanism than serotonergic psychedelics. While classic psychedelics primarily act on the 5-HT2A receptor, ketamine’s primary mode of action is through NMDA receptor antagonism. However, this distinction is irrelevant to the subjective and therapeutic outcomes. The states of consciousness ketamine facilitates can catalyze profound psychological healing, just as serotonergic psychedelics do.
Ketamine's pharmacological profile makes it one of the safest options for many individuals seeking psychedelic-assisted therapy. Unlike serotonergic psychedelics, ketamine has few significant interactions with medications, including selective serotonin reuptake inhibitors (SSRIs), which many individuals rely on. This makes it an excellent option for those who cannot taper off their existing medications.
Additionally, ketamine’s dissociative mechanism reduces the likelihood of triggering adverse psychological events like mania or psychosis. While serotonergic psychedelics have been known to precipitate these conditions in vulnerable individuals occasionally, ketamine’s effects are more transient and neurochemically distinct, making it a safer alternative for high-risk populations.
Critics of ketamine often raise concerns about its potential for dependence and physical complications. While it is true that ketamine has a dependence liability, this risk is frequently exaggerated. In clinical settings, ketamine is administered under strict protocols with limited opportunities for misuse. The dependence risk is negligible compared to the therapeutic benefits it offers in controlled environments.
Physical complications, such as bladder issues, are rare in the clinical context. These complications are more commonly associated with frequent recreational use, where doses far exceed therapeutic levels. With proper medical oversight and adherence to evidence-based protocols, the risks of ketamine therapy are minimal.
The research supporting ketamine-assisted psychotherapy (KAP) is robust and growing. Studies have consistently demonstrated ketamine’s efficacy in treating major depressive disorder, treatment-resistant depression, addictions, and post-traumatic stress disorder (PTSD). Furthermore, KAP integrates ketamine’s neuroplastic effects with therapeutic guidance, enhancing its potential to promote long-lasting psychological change.
For instance, ketamine’s ability to rapidly alleviate depressive symptoms—sometimes within hours—is unparalleled. Combined with psychotherapy, these immediate effects can create a unique therapeutic window in which patients are more receptive to exploring and integrating their experiences. Emerging research also highlights ketamine’s capacity to foster connection and meaning, essential components of the psychedelic experience.
Dismissing ketamine as “not a real psychedelic” perpetuates harmful biases and limits the tools available to those seeking healing. Ketamine’s distinct mechanism of action and therapeutic potential should be celebrated as complementary, not inferior to classic psychedelics. By moving beyond drug exceptionalism, the psychedelic community can foster inclusivity and innovation—values essential to the transformative power of these medicines.
Ketamine deserves its place in the pantheon of psychedelics, not as an outlier but as an indispensable ally in the pursuit of mental health and human flourishing.