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Comment by atomical | Hacker News Reader

I take 250mg sublingual. I put it under my tongue at night while listening to music.

Can you describe your experience with it (how resistant your depression was, how effective ket is, what the short and long term effects you’re noticing are)?

I had tried several anti-depressants before ketamine. I feel a lot better and have much more energy.

A side effect while taking the drug in the short term is dissociation. As tolerance builds that eventually goes away.

I'm having some issues with sleep and productivity at night.

Is that a standard dose? Why do you take it sublingually instead of snorting it?

I have taken ketamine recreationally...that is quite a high dose at least from my experience, though I've never though to take it sublingually.

There isn't a standard dose. Far too early for that.

I take it sublingually because that's what my doctor prescribes.

Doc here. Sublingual application bypasses the liver, which removes drugs from the bloodstream. Same reason why nitro is applied here.

That’s interesting. What’s the mechanism for that? Uninformed intuition would lead one to think there would not be a difference.

It's a function of anatomy. The sublingual veins drain into the jugular and then vena cava. For drugs this avoids the first-pass effect, which is exploited when giving nitroglycerin for angina pectoris. Other ways to achieve this are suppositories (rectal veins) and intravenous (i.v.) or intramuscular (i.m.) injection.

https://en.wikipedia.org/wiki/Lingual_veins

https://en.wikipedia.org/wiki/First_pass_effect

Some of the drug will always be absorbed orally and travel to the liver through the the portal vein.

The liver will eventually remove ketamine from the bloodstream regardless of which route is used.

That's my understanding at least.

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