In recent years, ketamine has been gaining recognition for its ability to treat conditions like depression, post-traumatic stress disorder (PTSD), and chronic pain. When administered under careful clinical supervision, ketamine can provide fast-acting relief when other treatments have failed. But as its use becomes more common, so do questions about how long ketamine stays in the body.
In this article, we’ll share what you need to know about therapeutic ketamine and how long it stays in your system – with a focus on clinical, and not recreational, use.
When is ketamine used in a clinical setting?
Ketamine is used in clinical settings to address a range of treatment-resistant mood and pain disorders, including:
- Treatment-resistant depression (TRD): Ketamine can provide fast relief for those who haven’t responded to traditional antidepressants or therapy.
- Major depressive disorder with suicidal thoughts: Because ketamine works quickly, it can be used to reduce suicidal ideation in the time it takes for antidepressants to take effect.
- PTSD: Some studies suggest that ketamine can help reduce intrusive thoughts and emotional distress linked to trauma.
- Chronic pain conditions: At lower doses, ketamine may help relieve pain associated with conditions like fibromyalgia.
Note that ketamine isn’t typically a first-line treatment – it’s often recommended only when other treatments haven’t worked or when rapid symptom relief is urgently needed.
Keep Reading: What to Do When Antidepressants Don’t Work for You (and Why)
How is ketamine administered?
In most clinical cases, ketamine is administered via intravenous (IV) infusion or intramuscular (IM) injection in a controlled environment. There is also an esketamine nasal spray (Spravato®) that is FDA-approved and administered under supervision.
What is esketamine?
Esketamine is a nasal spray form of ketamine, approved by the FDA under the brand name Spravato®. Esketamine is used to treat major depressive disorder (MDD) in individuals who haven’t responded to at least two traditional antidepressants (otherwise known as treatment-resistant depression).
Like other forms of ketamine, esketamine is used in clinical settings under medical supervision. It may be used on its own or alongside an oral antidepressant, depending on the patient’s treatment history. Although patients were required to continue taking oral antidepressants when esketamine was first approved, this is no longer mandatory.
Spravato® treatment involves a structured dosage schedule:
- Twice a week for weeks 1 to 4
- Once a week for weeks 5 to 9
- Once every 1 to 2 weeks following that.
Each esketamine dose is administered in a clinical setting with patients monitored for at least two hours afterwards. This observation period is necessary as the drug can cause potential side effects like sedation, dizziness, or temporary cognitive impairment.
When used appropriately, esketamine can be a life-changing option for people who have struggled to find relief from conventional depression treatments. Learn more about this revolutionary treatment here.
How long does ketamine last?
IV ketamine takes effect within seconds, while IM injections begin working in about four minutes. The active effects usually last between 15 and 30 minutes, depending on the dose and method of administration.
At therapeutic doses, ketamine induces mild sedation, pain relief, and altered consciousness, without the intense dissociative effects seen at higher, non-medical doses.
When used recreationally – often snorted, smoked, or taken orally – the onset is still relatively fast and effects may last 30 to 60 minutes, often with distorted perceptions and dissociation.
Read More: The Difference Between Ketamine and Esketamine
What is the half-life of ketamine?
The half-life of ketamine in adults is typically around 2.5 to 3 hours. This refers to the amount of time it takes for the concentration of ketamine in the body to reduce by half. Even though the active effects of ketamine last only 15 to 30 minutes when administered therapeutically, the drug remains in the body long after those effects wear off.
In most cases, it takes about four to five half-lives – or roughly 10 to 15 hours – for ketamine to be eliminated from the body completely. However, elimination timelines can vary depending on a person’s metabolism, age, liver function, body composition, and overall health.
Does ketamine show up on drug tests?
Yes, ketamine can show up on drug tests, but it’s not usually part of most standard drug screening panels. Tests used by employers, healthcare providers, or legal systems often screen for substances like opioids, cannabis, cocaine, amphetamines, and benzodiazepines, but not usually ketamine.
However, there are specialized drug tests that can be ordered to detect ketamine. These tests are widely available and can identify ketamine and its metabolites, like norketamine and dehydronorketamine, in various parts of the body.
If you’re concerned about drug screening for medical, legal, or employment reasons, speak to your provider about timelines and documentation for therapeutic use.
How is ketamine detected on drug tests?
The most widely used method to detect ketamine is through a urine drug test. This test targets ketamine’s metabolites, which remain in the body much longer than ketamine itself (which is typically only detectable for about 24 hours in urine). Research shows that metabolites like norketamine can be detected in urine for up to 14 days following a single intravenous dose.
Some common methods used to detect ketamine include:
- Urine tests: These are the most common, able to detect ketamine and its metabolites for days after use
- Saliva and blood tests: These are less common, but can detect ketamine for up to 1 to 3 days after use
- Hair tests: These can show drug use over the past 90 days, but they’re less frequently used in employment settings.
Continue Reading: What are the Possible Side Effects of Spravato?
How long does ketamine stay in your system?
The active effects of ketamine wear off within 30 to 60 minutes, but the drug and its metabolites can remain in the body much longer, especially when measured by drug tests. To understand how long ketamine stays in the system, it’s helpful to look at how the body processes it.
Once ketamine is administered (either intravenously or intramuscularly), it’s metabolized by the liver into compounds like norketamine and dehydronorketamine. These metabolites are then eliminated through urine, and to a lesser extent, through the breath. About 90% of ketamine and its byproducts are excreted via urine.
In most healthy adults, ketamine is fully metabolized and cleared from the body in about 10 to 15 hours. However, traces of the drug or its metabolites can be detected by drug tests well after the clinical effects have worn off. This is because sensitive testing methods can detect even small residual amounts in various body tissues.
It’s estimated that ketamine remains detectable for:
- Saliva: Up to 48 hours
- Blood: 1 to 3 days
- Urine: Several days up to 2 weeks, depending on dose and frequency of use
- Hair follicles: Up to 90 days, starting around 7 to 10 days after use
- Breast milk: Trace amounts may be present – use of ketamine during breastfeeding is generally not recommended without medical guidance.
Ketamine detection times can vary widely depending on factors like dosage, frequency of use, body weight, liver function, and metabolism. Because therapeutic use often involves controlled, lower doses, it may clear more quickly than with recreational use or high-dose exposure.
Factors that affect how long ketamine stays in the body
How long ketamine stays in the body varies from person to person. Factors that can affect how long ketamine remains detectable include:
Dosage
Larger doses of ketamine take longer to break down and eliminate. Ketamine doses are carefully controlled in therapeutic settings, but if a person takes higher doses or repeated doses – like with ketamine abuse or misuse – it can stay in the system longer.
See: Spravato Dosage: Form, Strength & How to Take
Frequency of use
When a person uses ketamine occasionally, it clears the system more quickly than with frequent use. This is because repeated exposure can cause ketamine and its metabolites to accumulate, which then takes longer to fully eliminate from the body.
Route of administration
Ketamine can be administered intravenously, intramuscularly, orally, or intranasally. Injected ketamine is absorbed more efficiently and may be metabolized differently than ketamine taken by mouth or snorted.
Metabolism
People with faster metabolic rates tend to process and eliminate drugs more quickly. Age, genetics, activity level, and overall health can all influence a person’s metabolic speed.
Liver and kidney function
Ketamine is primarily processed by the liver and excreted through the kidneys. Because of that, people with impairments in liver or kidney function might eliminate the drug slower.
Read: Do Antidepressants Work and How Effective Are They?
Hydration levels
Ketamine is largely excreted through urine, so staying well-hydrated may help flush the drug and its metabolites from the system more quickly.
Body mass
Higher body mass can dilute the relative concentration of ketamine, sometimes leading to faster elimination. But this can vary depending on how the body distributes and stores the drug.
General health
Healthier individuals may eliminate ketamine faster than those with health conditions, especially those affecting the liver, kidneys, or metabolism.
Mixing with other drugs
Taking ketamine alongside other substances can compete for the body’s metabolic resources, potentially slowing down the elimination process.
Are there ketamine withdrawal symptoms?
In a clinical setting, ketamine is carefully administered in controlled doses under medical supervision to reduce the risk of physical dependence or withdrawal. But when ketamine is used frequently at high doses, such as in recreational or unsupervised settings, it can cause withdrawal symptoms when stopped abruptly.
Ketamine doesn’t usually cause physical withdrawal symptoms in the same way that substances like opioids or alcohol can. However, some people may experience psychological withdrawal effects, such as:
- Cravings for the drug
- Anxiety or restlessness
- Fatigue or low energy levels
- Irritability or mood swings
- Difficulty sleeping
- Problems with focus or memory.
If you’re worried about the potential for ketamine addiction or withdrawal, don’t be afraid to contact us to discuss your concerns.
FAQs: How long does ketamine stay in your system?
Below we answer some common questions about ketamine.
How long do the effects of ketamine last after treatment?
When administered therapeutically (via IV or IM), ketamine’s active effects begin within minutes and usually last 15 to 30 minutes. Some people may feel lingering sensations, like lightness or fatigue, for a few hours after treatment.
How long does ketamine stay in your body?
Ketamine itself is usually eliminated from the body within 10 to 15 hours, but traces of the drug and its metabolites can remain detectable in drug tests for several days or even weeks, depending on the type of test and a person’s metabolism.
Can ketamine be detected on a drug test?
Yes, but ketamine isn’t typically included in standard drug screenings. It can only be detected through a specialized ketamine drug test that specifically looks for ketamine and its metabolites.
What factors affect how long ketamine stays in the body?
Several factors influence how long ketamine stays in your system, including dosage, frequency of use, route of administration, age, body weight, metabolic rate, hydration levels, and liver and kidney function.
Will therapeutic ketamine show up in a drug test?
Yes, therapeutic ketamine can show up on a drug test, but only if a ketamine-specific test is used. If you’re receiving prescribed ketamine or esketamine therapy, you should inform your employer or testing authority in advance.
How long can ketamine be detected in urine?
Ketamine itself may be detectable in urine for 1 to 3 days, but its metabolites can be found for up to 14 days, depending on dosage and other factors.
Summary: How long does ketamine stay in your system?
Ketamine has shown to be an effective tool in treating mental health conditions like severe depression and PTSD, especially when other therapies haven’t worked in the past. If you’re exploring ketamine as a potential therapy, it can help to understand how it’s processed and metabolized by the body.
For any questions about ketamine or esketamine treatment, don’t hesitate to contact our team at BestMind Behavioral Health. We’ll be happy to discuss whether this approach is right for you and support you on your journey to better physical and mental health.
