Ketamine Use in Self-Described Therapeutic Contexts: A Thematic Analysis of Reddit Posts

An analysis of 500 high-engagement threads (12,852 comments) from the r/TherapeuticKetamine subreddit found that people primarily use ketamine for mood-related concerns (53%). Positive effects, most often improved emotional well-being (65%), were reported alongside adverse effects that were predominantly psychological or mood-related (56%). 70% of reported doses exceeded 149 mg, indicating a trend toward higher doses. Intravenous administration (40%) and sublingual troches (23%) were the most common routes. Concurrent use of prescribed psychotropics, cannabis, and psychedelics was also reported. The findings suggest substantial heterogeneity in individual experiences and underscore the importance of clinical monitoring for addiction potential and drug interactions.

Study at a glance

Abstract

The use of ketamine for the management of neuropsychiatric conditions outside clinical settings has rapidly expanded, creating a critical need to understand diverse individual experiences. We conducted a qualitative content analysis of posts from the r/TherapeuticKetamine subreddit. From 3302 threads, the 500 highest-engagement threads (12,852 comments) were analyzed by independent coders across six domains: perceived positive effects, adverse effects, reasons for use, route of administration, polydrug use, and dose amounts. Mood-related concerns were the primary reason for use (53%). Users reported positive effects, most often improvements in emotional well-being (65%). Adverse effects were predominantly psychological or mood-related (56%). A total of 70% of reported doses exceeded 149 mg, suggesting a trend toward higher dose use. Intravenous administration (40%) and sublingual troches (23%) were the most frequently reported routes. Concurrent use of prescribed psychotropics, cannabis, and psychedelics was also reported. This analysis identified substantial heterogeneity in individual-reported experiences. Frequent high-dose use, dose escalation, and polydrug exposure underscores the importance of clinical monitoring and attention to addiction potential and drug-drug interactions. The findings should be interpreted with caution, as follow-up and clinical verification were not possible; however, the data provide an unfiltered view of individual experiences in relation to ketamine use outside the clinical setting.