Dissociatives: Ketamine, PCP, DXM, Nitrous
Ketamine is now an FDA-approved antidepressant. It's also a recreational drug with an emerging use disorder pattern. Both are true.
Body — 8 lenses: [Science: NMDA receptor antagonism (ketamine, PCP, DXM), nitrous as N2O NMDA + opioid. Biology: dissociation at moderate doses; K-hole at higher; ketamine bladder toxicity with chronic recreational use; B12 deficiency and neuropathy from nitrous. Psychology: dissociative experience; emerging ketamine use disorder pattern; the therapy/recreation confusion. Policy: ketamine Schedule III; esketamine (Spravato) FDA-approved for TRD; nitrous legal and lightly regulated; PCP Schedule II. Trends: ketamine clinics exploding; WhipIt+ canister culture; DXM abuse among adolescents declining. Social: the “ketamine therapy” wellness wave, Matthew Perry’s death and accountability. Treatment: ketamine use disorder — sparse evidence, harm-reduction-heavy approach. Harm reduction: nitrous B12 supplementation, ketamine urinary-tract monitoring, don’t mix dissociatives with depressants.]
Sources Cited
- 01.Ahttps://clinicaltrials.govClinicalTrials.gov
- 02.A
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