It’s safe to say that ketamine has had the rebrand of the century. Previously a scatty drug taken at the grisly end of an afters, it’s now a ‘chic’ fashion statement and promising treatment for depression used by Elon Musk. Musk, who once lost money for smoking a joint on the Joe Rogan podcast, reportedly microdoses ketamine, occasionally taking it in higher doses at parties or with friends. While Musk hasn’t admitted this outright, he did tweet (or X’d?) that he believed ketamine “taken occasionally is a better option” than “zombifying people with SSRIs”. 

He’s not exactly wrong. Research has found that ketamine may be used to treat depression as well as addiction to alcohol, heroin and cocaine. This is because of its ability to increase neuroplasticity and neurogenesis, the same way LSD and shrooms do. “Although ketamine is considered a psychedelic, it isn’t a classic psychedelic like LSD and psilocybin,” explains Ivan Ezquerra-Romano, a neuroscientist and director of the harm reduction organisation drugsand.me. While the latter binds to 5-HT2A receptors in the brain, ketamine binds to NMDA receptors, but both work to create new neurons and neural connections. “Often it’s considered that in mental health conditions and addiction, there are not the right amount of connections between neurons and that there are fewer neurons in key areas,” Ezquerra-Romano adds. “Ketamine helps with this.”

While microdosing ketamine is much less common than microdosing shrooms, for example, ketamine treatment is becoming more common in clinical settings, so it’s no surprise that some people are beginning to self-medicate with the drug. That said, ketamine is not without its dangers, and some researchers think the positive effects we get from microdosing may be down to a placebo effect. With little evidence that ketamine improves the wellbeing of people in disorders who don’t suffer from these disorders, it’s not clear how worth it would be for someone with good mental health to bother. Either way, if you’re curious, here’s everything you need to know.

FIRST, THE DANGERS

The main dangers of microdosing ketamine are damage to the nostrils, as well as bladder issues, which are both caused by long-term use. ‘Ketamine Bladder’ has symptoms similar to cystitis or a UTI. “You might have pain when you urinate, or need to urinate more frequently,” says Ezquerra-Romano. If these issues persist, it’s a good idea to stop using ketamine, because the damage can be irreversible. 

If you snort ketamine often, you might damage your nostrils – which can also be permanent. This looks like nose bleeds, a reduced sense of smell, difficulty swallowing, a hoarse voice and, in more extreme cases, a hole in the nasal septum. It’s vital you look out for this and take breaks when necessary.

Another thing to be aware of with ketamine is that your tolerance increases pretty quickly. If you take ketamine recreationally, it’s likely you’ll have to take more to get the same effects. While there aren’t any physical withdrawal symptoms, it is possible to become dependent on ketamine, which will increase the risk of other side effects such as bladder and nostril damage as well as psychosis. 

Finally, as always, if you’re buying ketamine on the black market, you need to test your gear. Whether you’ve been from the same source for years or not, it’s vital you test your drugs to make sure you’re taking what you think you’re taking. Oh, and ketamine is illegal, so you could be sentenced to jail or handed an unlimited fine if you’re found with ketamine more than once. 

Still want in? Here’s how to microdose ketamine as safely as possible.

HOW TO DOSE IT

Usually, people are given a ‘sub-anesthetic dose’ of ketamine in formal treatment, but this isn’t the same thing as a microdose. According to Ezquerra-Romano, a microdose is anything below 0.2 milligrams of ketamine per kilogram of bodyweight (so someone who weighs 70 kg shouldn’t take more than 14 mg). It’s best, of course, to start low with 0.1 mg/kg, or maybe even less, while you feel out the effects. 

HOW TO TAKE IT

Once you have the dose, you’re just going to snort it as normal. While ketamine is often administered through an IV drip or taken orally in clinical settings, these don’t really work for people self-medicating. You can theoretically get a ketamine nasal spray on prescription on the NHS, but it’s quite rare, and you need to be diagnosed with treatment-resistant depression. 

FOLLOW A PROTOCOL

People who microdose with psychedelics often follow a protocol. For people who use shrooms, this usually looks like taking a microdose every two or three days and taking a break every few weeks to avoid building tolerance. There’s little research on ketamine microdosing protocols, so Ezquerra-Romano recommends waiting a little longer than you would with LSD and mushrooms, maybe between five and seven days. 

Whether you’re microdosing or taking larger doses, it might be a good idea to keep a microdosing journal – or even just a record on your notes app – where you report the dose, the effects and the aftereffects. Over time, you can increase or decrease your use depending on your findings. 

Curious about microdosing mushrooms? Find our guide here.

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