Ketamine Liquid hydrochloride is a medication typically supplied as a clear, colorless liquid solution for injection (e.g., 10 mg/mL, 50 mg/mL, or 100 mg/mL concentrations). It’s a Schedule III controlled substance in the US (DEA classification) and similarly regulated worldwide due to its anesthetic and dissociative properties. Pharmaceutical versions are sterile and used medically; illicit “liquid ketamine” is often diverted from veterinary or human medical supplies.

Medical Uses

• Anesthesia: Primary use as a rapid-acting general anesthetic, especially in emergencies, surgery, or field medicine (e.g., battlefields). It induces a “dissociative” state without fully depressing breathing.
• Pain Management: Low-dose infusions for chronic pain (e.g., CRPS, neuropathic pain).
• Mental Health: Emerging off-label use for treatment-resistant depression via low-dose infusions (e.g., esketamine nasal spray like Spravato is FDA-approved; liquid form used in clinics).
• Veterinary: Common in animal anesthesia (e.g., cats, horses).

Evidence: Approved by FDA in 1970. Studies (e.g., JAMA Psychiatry 2018 meta-analysis) show rapid antidepressant effects lasting days to weeks. WHO lists it as an essential medicine for anesthesia.

Pharmacology and Effects

Ketamine is an NMDA receptor antagonist, blocking glutamate signaling in the brain, leading to:

Pharmacokinetics:

• Onset: IV (immediate), IM (5-10 min), intranasal (5-15 min).
• Half-life: 2-3 hours.
• Metabolized in liver to norketamine (active metabolite).

Side Effects/Risks:

• Short-term: Hypertension, nausea, vomiting, emergence delirium (“bad trips”).
• Long-term/Chronic: Cystitis (bladder damage, “ketamine bladder” – ulcerative inflammation in 20-30% heavy users per Urology 2012 study), cognitive impairment, dependence.
• Overdose: Respiratory depression rare but possible with combos (e.g., alcohol, opioids). LD50 in humans ~100-300 mg/kg (extrapolated from animal data).

Legality and Availability

Street liquid ketamine is often sourced from vet clinics (e.g., for horses) and sold in vials or diluted for nasal/oral use. Purity varies; contaminants common.

Administration (Medical Context)

• IV/IM: Hospital setting only.
• Intranasal: 20-50 mg sprays for depression (clinic-supervised).
• Oral: Less bioavailable (~25%), used experimentally.

Safety Note: Non-medical use highly risky – combines with depressants can cause fatal apnea. Tolerance builds quickly; withdrawal includes cravings, anxiety.

For medical advice, consult a doctor. Sources: