Ketamine Induced Nausea and Vomiting: Tips and Prevention

Ketamine's effectiveness in treating certain mental health conditions like depression and anxiety has been increasingly recognized. Its rapid action and potential for producing significant improvements in mood and outlook, where other treatments have failed, make it a promising option. However, with this rise in usage, understanding and addressing the common side effect of nausea and vomiting becomes even more important.

Why Nausea Occurs with Ketamine

Woman with dizziness and nausea
  1. Central Nervous System Effects: Ketamine acts on the central nervous system, affecting various neurotransmitters. It can disrupt the normal functioning of the vestibular system, responsible for balance and spatial orientation, leading to dizziness and nausea.

  2. Gastrointestinal Irritation: Ketamine may irritate the gastrointestinal tract, leading to nausea and vomiting.

  3. Psychological Factors: The dissociative effects of ketamine can cause psychological discomfort, which might manifest as physical symptoms like nausea and vomiting.

Timing and Commonality

  • During Comedown: Nausea is particularly common during the comedown phase of ketamine use. This period is marked by a return to normal consciousness, which can be disorienting and might trigger nausea, especially if the user attempts to walk or move around too soon.

  • Frequency: The incidence of nausea with ketamine varies among individuals, but it is a relatively common side effect.

Vomiting: Short-lived and Self-limiting

  • Duration: Vomiting induced by ketamine is usually short-lived and resolves on its own without the need for extensive medical intervention.

Prevention Tips

  1. Fasting: Avoid eating for at least 6 hours before using ketamine to reduce the likelihood of nausea and vomiting. Vomiting can be more uncomfortable and distressing if it occurs with undigested food in the stomach.

  2. Handling ODT Residue: With orally disintegrating tablets (ODTs) of ketamine, it's advisable not to swallow the residue. Instead, spitting it out can help reduce gastrointestinal irritation.

  3. Resting Post-Use: Lying in bed for a longer duration post-ketamine use, especially until the dizziness passes, can mitigate nausea. Once the dizziness subsides, it is generally safe to start walking.

  4. Antiemetics: Taking Zofran (ondansetron) ODT at the onset of nausea can effectively manage the symptom.

Vomiting as a Form of Purge

  1. Physical and Mental Purge: Some individuals view vomiting as a form of physical and mental purge, cleansing the body and mind. It's not necessarily seen as a negative experience, and some may prefer not to prevent it.

  2. Avoiding Resistance: For those who consider vomiting a part of the ketamine experience, resisting this urge may detract from their experience. They may choose to embrace it as a form of release.

Impact on Individuals with Emetophobia

For those with emetophobia, the fear of vomiting, ketamine use presents a unique set of challenges and opportunities:

  1. Facing the Fear: The prospect of nausea and vomiting while using ketamine can be daunting for someone with emetophobia. However, this experience can also serve as a controlled environment to confront and potentially overcome their fear.

  2. Safe Environment for Exposure: Under medical supervision, using ketamine can provide a safe setting for individuals to face their fear of vomiting. This exposure, in a controlled and supportive environment, can be therapeutic in its own right.

  3. Healing Opportunity: For some, the experience of nausea or vomiting during a ketamine session might contribute to a broader therapeutic process. It can be seen as a physical manifestation of releasing deeper psychological distress.

  4. Professional Guidance is Key: It's crucial for individuals with emetophobia to discuss their fears with a healthcare provider before using ketamine. This ensures that their experience is appropriately managed and that they receive the support they need.

Summary

In summary, while nausea and vomiting are common side effects of ketamine , they are generally manageable and often viewed differently by individuals. Personal preferences and perceptions play a significant role in how these symptoms are addressed. As with any medication, using ketamine responsibly and under proper guidance is crucial to minimize risks and manage side effects effectively.


Discreet Ketamine provides ketamine therapy for at-home treatment to Florida residents.


Dr. Ben Soffer

Former chair of Internal Medicine at St. Mary’s Medical Center in West Palm Beach, Florida and associate professor at FAU Medical School. Dr. Ben is the owner of a concierge Internal Medicine practice in Palm Beach County, Florida and Discreet Ketamine, a telemedicine mental health practice servicing the entire state. He resides in Boca Raton, Florida with his wife and four children.

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