What if ketamine triggers dissociated memories of trauma events?

Open-label ketamine trials and research studies are currently active or recently completed in Australia. These focus on PTSD, depression, suicidality, and addiction. Developmental trauma can underlie these mental health disorders. Rationale for open-label ketamine trials over double-blind administration includes greater informed consent, improved efficacy, and greater safety. Yet, ketamine administration to subjects with extreme trauma and dissociation histories may be unsafe due to potential state-dependent effects. Here is a summary of some relevant factors:

1. PTSD subjects may possess more complex trauma histories than initially indicated. Severe trauma events underlying PTSD can include drug administration paired with torture and/or near-death experiences.
2. The full ways Ketamine acts are not yet completely identified, especially on opioid receptors . Ketamine effects are varied and dose-dependent, plus subjects possess unpredictable drug-sensitivity levels.
3. State-dependent learning phenomena determine that drugs can place subjects in altered states of consciousness (ASC). Once sober, subjects forget what occurred during the drug-induced ASC but recall these state-dependent memories when returned to the same state. Information transfer can occur between drug-induced states that share similarities.
4. Ketamine in subanesthetic doses can induce ASCs. The relationship between ketamine and dissociation is unknown.
5. Ketamine’s effects resemble PTSD symptoms of dissociative flashbacks, hypervigilance, intrusive thoughts, and unwanted memories. Ketamine’s sympathomimetic effects resemble PTSD sympathetic hyperactivity (as indicated by elevated heart rate, blood pressure, and sweating). These effects could be generalised to trigger trauma event flashbacks.
6. Heart failure features autonomic NS imbalance, with increased sympathetic activity and decreased parasympathetic (vagal) activity. The vagus nerve regulates the interaction between emotion and the heart, lungs, and stomach. It specifically influences left ventricular function, mainly by regulating heart rate and contraction. Extreme threat is known to trigger vagal ‘collapse’ as indicated by plummeting vital signs.
7. Extreme emotional stress can cause sudden heart failure. The main indicator of this ‘stress (Takotsubo) cardiomyopathy’ condition is abnormal activity in the left ventricle. Cases of Takotsubo cardiomyopathy following subanesthetic-dose ketamine administration are documented. Researchers note that Ketamine’s sympathomimetic effects could theoretically induce stress-related cardiac dysfunction, including cardiomyopathy.

It is hypothesised that low-dose ketamine administration to PTSD test subjects could trigger extreme trauma event memories acquired during drug-induced dissociative states. Ketamine administration to victims of ritual abuse and mind control whose programming was laid via drug administration coupled with multiple near-death experiences could prove fatal.

© Fiona Rae Barnett