Ketamine, a dissociative anesthetic, is used for anesthesia, pain management, and treatment-resistant depression, but safety concerns persist. This review summarizes adverse effects, particularly cardiovascular, neuropsychiatric, and dependency risks. Evidence-based guidelines for administration, dosing, and monitoring are discussed, emphasizing risk-benefit assessments. Future directions include enhanced safety protocols, long-term outcomes, and individualized dosing.
Psilocybin, a naturally occurring psychedelic compound, shows promise as a treatment for major depressive disorder, especially when traditional therapies fail. Evidence from clinical studies between 2014 and 2024 indicates that psilocybin acts on serotonin 5-HT2A receptors, enhancing neuroplasticity and brain connectivity to produce rapid and sustained symptom relief. However, its classification as a Schedule I substance in many countries and societal stigma have restricted research and use. Overcoming regulatory barriers, conducting larger and more diverse studies, and establishing long-term safety and efficacy data are critical for integrating psilocybin into mainstream mental health care.
Chronic opioid use may dampen the neuroendocrine response to surgical stress. In a rat model, animals addicted to morphine or opium showed lower corticosterone levels after laparotomy than controls, though the difference was not statistically significant. Blood glucose, a marker of stress-induced hyperglycemia, was significantly higher in control rats both immediately after surgery and 30 minutes later, indicating a sustained response that was blunted in addicted rats. No significant differences emerged between morphine- and opium-addicted groups. The findings suggest that long-term opioid exposure can alter the body's hormonal stress response, potentially affecting recovery from surgery. However, the small sample size and lack of baseline measurements limit the conclusions.