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Why You Might Feel Nauseous After A Ketamine Treatment

Synopsis: Experiencing nausea after a ketamine treatment is more common than you might think, but why does it happen? Find your answers in this blog and you’ll learn how ketamine's interaction with the vestibular system, along with its effects on NMDA, dopamine, and serotonin receptors, can lead to feelings of nausea.

This blog post has been adapted from our Why Do I Feel Nauseous After A Ketamine Treatment? video.


If you're wondering why you feel nauseous after a ketamine treatment, you’ve come to the right blog. Here, we’ll explain the reasons behind this common side effect, plus some options that you can discuss with your ketamine specialist.

One of ketamine’s side effects is nausea.

Understanding Nausea After Ketamine Treatments

Why are you feeling nauseous? There are several factors to consider. First, ketamine can sometimes stimulate the vestibular system, the part of our brain that helps us maintain balance. Many patients report feeling dizzy, a symptom primarily due to the impact of ketamine on the vestibular system. 

One common symptom we observe in patients is nystagmus, where the eyes shift back and forth, typically seen during dissociative and subdissociative states of ketamine therapy. Secondly, ketamine primarily affects the NMDA (n-methyl d-aspartate) receptors but also impacts dopamine and serotonin receptors. Stimulation of these receptors can frequently cause nausea. Fortunately, there are various medications available to prevent this, which we’ll discuss later in this blog.

Exploring the Gut-Brain Connection & Spiritual Dimension in Ketamine Side Effects

Another factor is the gut-brain connection. Did you know the enteric nervous system and the central nervous system originate from the same embryonic cells, the neural crest cells? This means many receptors found in the brain are also in our gut. This connection explains why some patients on antidepressants or other psychiatric medications experience gut-related side effects. For example, irritable bowel syndrome (IBS) often coincides with conditions like anxiety and depression. 


Lastly, consider a possible spiritual or energetic connection to nausea. Sometimes, when patients recall traumatic or adverse experiences, they report feeling 'sick to their stomach.' This reaction underscores the profound link between our psyche and our gut.

Through proper preparation and use of various medications, it is possible to reduce the feelings of nausea after the ketamine treatment.

Preventing and Addressing Nausea During Your Ketamine Treatments

Now, let's discuss some preventative measures. At our clinic, like many other clinics, we have our patients fast before a ketamine infusion. Why? Because it is beneficial as it minimizes the chances of nausea by keeping the stomach empty. Plus, an empty stomach is important since ketamine can relax the esophageal sphincter, allowing stomach contents to move up the throat, potentially causing aspiration. 

We also prescribe various medications to help manage nausea. Zofran, or ondansetron, works as a serotonin receptor antagonist, effectively blocking the activity stimulated by ketamine. Another useful medication is Reglan, which blocks dopamine receptor activation, again countering effects induced by ketamine. Lastly, meclizine, also known as Antivert and available over-the-counter as Bonine, is commonly used for motion sickness. This gentle anti-cholinergic helps reduce stimulation of the vestibular system. Please remember to speak with your ketamine therapy specialist about what options are best for you.

Optimizing the Ketamine Experience: Managing Nausea Effectively

In conclusion, let's talk about how we handle that annoying nausea some folks experience after ketamine therapy. It's all about staying ahead of the symptoms with a solid plan. First off, understanding the vestibular system's role and how ketamine interacts with our brain and gut receptors is key. Also acknowledging that there can be a spiritual or energetic dimension to why the nausea is occurring can provide further insight to why it’s occurring. By knowing what triggers nausea, we can prepare better before diving into treatment. This includes fasting to keep the stomach settled and using meds like Zofran, Reglan, and meclizine to keep things smooth. It's crucial to chat with your ketamine specialist about these strategies to tailor a plan that fits just right. This way, you're not just managing symptoms—you're setting yourself up for the best possible experience during your ketamine journey.

Related questions:

What causes nausea during ketamine therapy?

  • Nausea during ketamine therapy can be caused by stimulation of the vestibular system, which affects balance and can lead to dizziness and symptoms like nystagmus. Additionally, ketamine's impact on NMDA, dopamine, and serotonin receptors can also induce nausea.

Why is the gut-brain connection important in understanding nausea after ketamine treatments?

  • The gut-brain connection is significant because many receptors found in the brain are also located in our gut, originating from the same embryonic neural crest cells. This connection helps explain why psychiatric medications, including ketamine, can have gut-related side effects like nausea, especially in conditions linked with psychological stress, such as IBS.

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Experiencing nausea after a ketamine treatment is more common than you might think, but why does it happen? Find your answers in this blog and you’ll learn how ketamine's interaction with the vestibular system, along with its effects on NMDA, dopamine, and serotonin receptors, can lead to feelings of nausea.


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