benzodiazepines and their negating effects of ketamine

[KemicalBurn]

Ive been doing numerous searches on why this happens. I recently learnt that if you are having a bad trip on ketamine, a small dose of benzos will counteract it and bring you back to normal.

while i know that its an ridiculous dose required to actually overdose on ketamine, bad experiences can and do happen, and this could prove helpful.

How i aquired this information: I have a friend who is a doctor and he did a presentation on ketamine and its use in hospitals and what to do if a patient is given too much K. Now, i didnt think too much of it, until a friend was having a bad k experience and he crushed up a valium and clonazepam and ~15mins later, things were normal. (this is second hand information, but extremely reliable and credible)

I havent had a chance to ask him of the mechanics on how and why this is and probably wont for some time, and ive done some searching about and i dont believe this is common knowledge - so ive decided to ask you clever cats in here about this.


thoughts? ideas?

 

[KemicalBurn]

also, im curious to know if its just ketamine or dissociatives in general. TIA for any help

 

[Blowmonkey]

Yeah, I'm also curious about this, specifically why benzo's can be used in combination with ketamine without causing respiratory failure. It just boggles the mind cause I keep finding contradicting stuff..

 

[BilZ0r]

Contradiction? To the classical wisdom that ketamine + anything = respitory depression? Who says it doesn't?

 

[Blowmonkey]

To the classical wisdom that ketamine + anything = respitory depression?

Benzodiazapines like versed are generally used along with ketamine during operations, how come they're used if there is a marginal greater risk of respiratory depression compared to other ways of anaestasia? And contradicting in the way that some places on the web are talking about this being a dangerous combination in case of respiratory failure and others say it's used all the time. I mean what's the deal?

 

[BilZ0r]

ketamine/midazolam, yup, it's a classic mix, like propofol/fentanyl. I -think- (I'm no anaesthetic expert) they do it because you get respitory depression with any combination of anaesthetic agents...
For example this

 

[eternalcrux]

heh, k+midazolam...thats gotta be a wild ride...

 

[Jamshyd]

^^^ Not really. Benzos are used with Ketamine in anaesthesia to combat "emergent reaction" (to us, that would be K-hole). As with the serotonergic psychedelics, benzos greatly reduce the psychedelic effects of Ketamine. So the "trip" would be pretty mellow.

I have personally take Ketamine + Benzos many times. I do this when I feel like taking ketamine but not experiencing any psychedellia. I also found benzos to be of great value to people with low K tolerance who seem to get a short period (around 30mins) of hyperexcitability at the end of the K trip. Benzos completely negate that.

As for Midazolam, it is not just all of the above, but it is also used purely for its amnesic properties - to make patients forget that they just had their stomach split open and their guts rearanged, for example, which would reduce postoperative stess/PTSD.

Also notices that Tiletamine, a Ketamine analogue and veterinary anaesthetic, is almost always foun in combination with Zelazolam ("Telazol"). I assume it is for similar reasons as the above.

I recall reading several studies in which tested Ketamine for respiratory depression alone and in combination with other depressants, and was found to have negligible effects on such. I can dig them up if anyone is really interested.

 

[paradoxcycle]

Originally posted by Jamshyd
I recall reading several studies in which tested Ketamine for respiratory depression alone and in combination with other depressants, and was found to have negligible effects on such. I can dig them up if anyone is really interested.

Safety of mixture of morphine with ketamine for postoperative patient-controlled analgesia: an audit with 1026 patients.

A comparison of fentanyl-propofol with a ketamine-propofol combination for sedation during endometrial biopsy.

Cardiorespiratory effects of diazepam-ketamine, xylazine-ketamine and thiopentone anesthesia in male Wistar rats--a comparative analysis.

The involvement of the mu-opioid receptor in ketamine-induced respiratory depression and antinociception.

The effect of low-dose ketamine on fentanyl-induced respiratory depression.

 

[blase deviant]

Is it safe to assume that in a recreational setting (no benzo antagonists, epinephrine/electropaddles, or respirator) that midazolam + ketamine is a bad idea?

I've mixed klonopin + ketamine before, and I assume xanax + ketamine would be similar and safe, but I know even oral midazolam on its own has had me breathing shallow (I kept taking more with my xanax because they didn't feel like they were working, next thing I know it's 5 hours later and I'm in bed, I fall back asleep, and wake up and my breathing is real shallow), but then again that was a lot, whereas I'd do less with ketamine.

Any comments?

The normal benzo + K mix sucks, it's a bit more sedating, but it didn't feel 'dopey' like I hoped, plus for some reason it just makes me wanna compulsively do more and more K when I'm on a benzo as compared to K alone, and it sorta wastes it. But I was hoping midazolam would give it that 'dope' feeling, but I'm scared of ODing.

 

[fastandbulbous]

Benzos help by acting as a muscle relaxant as ketamine on it's own has peripheral sympathetic activity and increases muscle tone - not good for certain types of surgical proceedure. As Jamshyd also said, the benzo/ketamine combination is also used to reduce the incidence and severity of 'emergent reactions', which while wanting to avoid them in clinical settings are the reason that people take it as a psychedelic drug. Without the emergent reaction you'd get none of the amazing 'rebirth' feeling that comes with the re-intergration of all your senses.

They can combine the two in a hospital setting as any respiratory depression can be overcome by mechanical ventilation means - something not available to most people using it in a non-clinical setting (that's you & me people!).

Generally, the short length of ketamine's action combined with the slow onset of most benzos means that it's not much use in combatting panic reactions that might occur. It would be of much more use with long acting dissociatives like PCP though