Concerns about ketamine’s impact on bladder and urinary health have emerged as ketamine has become popularized as a mental health treatment, primarily due to reports of misuse. Below, we clarify the relationship between ketamine use and urinary issues, including how these problems are typically associated with non-therapeutic use.
Ketamine & Urinary/Bladder Issues
Ketamine can cause bladder and urinary tract issues when used improperly or in high doses over extended periods. This condition, often called “ketamine bladder syndrome” or “ketamine cystitis,” can lead to symptoms such as frequent urination, urgency, pain, and even bladder inflammation.
Research indicates that these problems are primarily linked to recreational use, where individuals consume ketamine in unregulated and excessive amounts. In fact, recent research has found that people who use ketamine at least 3 times per week over a period of 2 years experience severe urological problems – the good news is that these symptoms appear to normalize after 1 year of ketamine abstinence.
Why Do Bladder and Urinary Issues Occur with Ketamine?
The exact mechanism by which ketamine affects the urinary system is not yet fully known, but a few factors are at play:
- Toxic Metabolites: Ketamine is metabolized in the liver, producing metabolites that may irritate the bladder lining when excreted in urine. Chronic exposure to these metabolites can lead to inflammation of, and damage to, the bladder (Zeng et al, 2017).
- Direct Irritation: Ketamine itself may have a direct irritant effect on the bladder epithelium, leading to leakage of irritative agents that cause inflammation and subsequent cystitis-like symptom (Jhang et al, 2015).
- Upper Tract Obstruction and Papillary Necrosis: Prolonged ketamine misuse can lead to severe conditions including upper tract obstruction and papillary necrosis, which can potentially result in renal failure. This is thought to be due to the toxic effects of high amounts of ketamine metabolites found in the urine, which disrupt the bladder epithelial barrier and trigger an inflammatory response.
While ketamine can lead to bladder and urinary issues when misused, these problems are not typically associated with therapeutic use under medical supervision. At Nushama, we prioritize safety by offering ketamine therapy exclusively through in-clinic intravenous (IV) infusions and the insurance-covered nasal spray, Spravato. Our treatment plans are carefully designed to ensure safe use, providing patients with effective mental health solutions without compromising their overall well-being.
