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Can Ketamine Cause Hallucinations or Psychosis?

Avatar photo Ian Young
28 Aug, 2025
05 min read

Introduction: A Mysterious Drug with Hidden Risks

Ketamine’s reputation is complicated. Known as both a powerful anesthetic and a party drug, its dissociative effects are often mistaken for harmless fun. But behind the “K-hole” allure lies a serious question: Can ketamine cause hallucinations or even psychosis?

At Holina Rehab Thailand, we work with clients every day recovering from ketamine misuse—including those navigating the psychological aftermath.

What Are Ketamine Hallucinations?

The “K-Hole” Explained

The infamous “K-hole” refers to a state of intense dissociation:

  • Disconnection from the body

  • Floating sensations

  • Time distortion

  • Inability to speak or move

While not all users enter a K-hole, those who do often describe it as hallucinatory—even frightening.

Types of Hallucinations Reported

  • Visual: Lights bending, colors melting, seeing people who aren’t there

  • Auditory: Hearing voices, echoes, or distorted sounds

  • Temporal: Feeling like time has stopped or looped

  • Spatial: Losing sense of where the body is in space

How It Feels vs. What’s Really Happening

Many describe the experience as dreamlike, but neurologically, the brain is undergoing extreme sensory misprocessing—not imagination.

Ketamine and Psychosis: Understanding the Connection

Can Ketamine Trigger Psychotic Episodes?

Yes. Especially in:

  • High doses

  • Chronic users

  • Those with family history of psychosis

Episodes may include:

  • Paranoia

  • Hallucinations

  • Delusions

  • Disorganized thoughts

Risks for Vulnerable Individuals

People with:

  • Schizophrenia

  • Bipolar disorder

  • Unresolved trauma

…are at much higher risk of a psychotic break or prolonged psychological disruption.

Medical Ketamine Use vs. Recreational Use

Controlled Clinical Doses

When administered medically:

  • The dose is small and brief

  • Patients are monitored in sterile environments

  • Sessions often include psychotherapeutic integration

Lack of Safety in Recreational Settings

Street ketamine use lacks:

  • Medical oversight

  • Dosage accuracy

  • Post-trip mental health support

This is where most psychotic-like side effects occur.

The Neurobiology Behind Ketamine-Induced Psychosis

NMDA Receptor Antagonism

Ketamine blocks NMDA receptors, which play a role in:

  • Learning

  • Memory

  • Emotional regulation

This disruption can cause cognitive distortion and sensory flooding—hallmarks of both hallucinations and psychosis.

Research Findings: Transient vs. Lasting Effects

  • Transient hallucinations: Most pass within hours

  • Lasting psychosis: Found in chronic or vulnerable users

Clinical studies (e.g., in Frontiers in Psychiatry) suggest repeated use may trigger schizophrenia-like symptoms, especially in youth.

Case Reports and Clinical Evidence

Documented Psychosis in Chronic Users

Reports include:

  • Paranoid delusions

  • Extended episodes of hallucination

  • Functional decline similar to drug-induced schizophrenia

Distinguishing Hallucination, Delusion, and Mania

Symptom Type

Description

Example

Hallucination

Perceiving things that aren’t there

Hearing voices, seeing shadows

Delusion

Believing false ideas strongly

Thinking you’re being watched or followed

Mania

Elevated mood with risky behavior

Grandiosity, insomnia, racing thoughts

Ketamine can cause all three—often in combination.

Holina’s Treatment for Ketamine-Related Dissociation

Trauma-Informed and Emotional Grounding

We help clients return to emotional presence through:

  • One-on-one therapy

  • Somatic processing

  • Group integration

Tools for Stabilization

  • Meditation and breathwork

  • Creative expression through art or music

  • Regulating nervous system with TRE and movement therapy

Clients are gently guided back to their bodies—often for the first time in years.

Frequently Asked Questions (FAQs)

Is it normal to see things on ketamine?

Yes—visual or auditory hallucinations can occur, especially in high or repeated doses. However, normal doesn’t mean safe.

Can one trip cause lasting psychosis?

Rare, but possible—particularly in people with mental health vulnerabilities. Most psychosis arises from repeated use.

Can ketamine worsen schizophrenia or bipolar disorder?

Yes. It can exacerbate existing symptoms or trigger episodes in those predisposed.

Is it safe to use ketamine if I’ve had hallucinations before?

No. Prior hallucinations may signal increased sensitivity or unresolved trauma—continuing use increases your risk.

What should I do if I or a friend is having a bad ketamine trip?

  • Keep the person safe from injury

  • Stay with them and speak calmly

  • Seek medical help if they lose consciousness or seem out of control

How does Holina help someone recovering from psychotic symptoms?

We offer:

  • Clinical oversight

  • Therapeutic grounding

  • Safe community support

  • Mind-body reintegration

Conclusion: Knowing the Risks Leads to Safer Decisions

Awareness is the First Step Toward Recovery

Ketamine can feel like an escape—but for some, it becomes a trap. Hallucinations are not harmless. Psychosis is not a myth.

Holina Supports Healing for the Mind and Soul

Whether you’re feeling detached, overwhelmed, or scared by past ketamine use—you’re not alone. Holina’s team offers the insight, safety, and support to reclaim your clarity and calm.

📞 Holina Admissions: +66 (0) 626 418 369

About Me

Avatar photo

Ian Young

Ian Young is the Global Manager at Holina Care Centres in Koh Phangan, Thailand. Ian oversees the rehabilitation programs that blend the 12 Step model, NLP, and various evidence-based therapies with holistic healing practices. Holina Rehab treats addictions, trauma, anxiety, and depression, offering comprehensive care in a serene resort environment. Ian, a charismatic speaker and author of “It’s Not About Me,” leverages his own recovery journey from addiction to inspire and guide others toward a fulfilling, addiction-free life.

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