Using Ketamine while on an SSRI

[shpongle1987]

Just started Zoloft and was wondering for future reference if I could still use ketamine will no adverse reactions. I've heard that you cannot mix DXM with ssr's due to serotonin syndrome but I am not 100% sure about mixing ketamine. I looked on bluelight and used google to check around but couldnt find any info.

 

[Thou]

Ketamine doesn't act on serotonin the way DXM does.

DXM is an SSRI itself as well as a releaser of serotonin, as well as having other nasty side effects that should be avoided whilst taking an SSRI.

Personally I've never noticed a difference in the ketamine experience with SSRI's (when I used to take them), and I certainly never had any adverse effects. YMMV. Perhaps someone with a little more personal experience could chime in and affirm what I've said by sharing their own experience/knowledge.

 

[swilow]

Yeah, you'll be fine to mix ketamine and zoloft. No notable interactions to be concerned with...

 

[Jesusgreen]

Actually, as far as I'm aware, Ketamine also affects serotonin, in a similar manner to DXM, but to a much lesser extent. Its main action is on dopamine.

Here's an abstract from a study:

Cognitive functions regulated by the prefrontal cortex are sensitive to changes in dopaminergic and serotoninergic transmission. The non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist ketamine influences dopaminergic transmission and induces psychotic symptoms in normal and schizophrenic individuals. This study examined the effect of single and repeated ketamine (25 mg/kg, i.p.) administration on extracellular levels of dopamine, GABA and the serotonin metabolite 5-hydroxyindoleacetic (5-HIAA) acid in the medial prefrontal cortex using in vivo microdialysis in conscious rat. In line with earlier studies, we observed a transient five-fold increase in dopamine release following single ketamine administration in drug naive animals. However, we also observed a two-fold increase in basal dopamine levels and an almost complete attenuation of the ketamine-induced increase in dopamine release in animals pre-treated with ketamine once daily for 7 days. Extracellular 5-HIAA levels were increased by ketamine in both drug naive and even more enhanced in ketamine-pre-treated animals but without a change in basal 5-HIAA levels. GABA levels were unaffected by either single or repeated ketamine administration. We demonstrate evidence for a differential effect of single and repeated ketamine administration on dopamine, serotonin and GABA transmission in the medial prefrontal cortex. We provide new evidence for a complex adaptation of neurotransmission following repeated NMDA receptor blockade whereby in the presence of increased basal dopamine levels the ketamine-induced increase in dopamine is attenuated and the increase in 5-HIAA is enhanced. It appears from our results that ketamine pre-treatment reduces the dynamics of dopaminergic transmission in the prefrontal cortex and may possibly alter the balance between dopamine and serotonin transmission.

tl;dr version: Ketamine leads to an increase a high increase in dopamine and a slight increase in serotonin. What it doesn't tell us though is if it's reuptake inhibiting (more likely) or releasing.

As for safety matters though, I still don't think it should be a concern, but personally I'd avoid repeatedly taking large doses after each other over a short period of time just to be sure, as if the action on serotonin has anything to do with the afterglow, it's likely these effects stack long after the high itself has worn off.

As I said though, unlikely to be a concern, but I'd be on the cautious side anyway.

 

[Thou]

Thanks for the info Jesusgreen, very helpful and informative.

 

[shpongle1987]

^^Wow thank's for those responses, I really appreciate that!! I think I will stick to using it on rare occasions and not doing multiple k-hole size doses in one night just to be safe

 

[Thou]

That'd be your best course of action regardless of Antidepressant therapy,

 

[lolusername]

I think ketamine itself might be a more effective anti-depressant then a ssri in the first place.

 

[shpongle1987]

^^^hahha i was thinking about trying out the ol'e ketamine as an anti-depressent use, but I could foresee myself getting hooked....no question. If it was legal go to a place where they could legally administer a couple doses a month just for the anit-depressent benefits, then I could see that being an amazing alternative for treating depression.