Safety considerations and risk mitigation strategies for ketamine use: a comprehensive review.
Reem Sayad, Ahmed Saad Elsaeidy, Amna M Anis, Mohamed Atef, Eslam A Hawash, Hager Adel Saad, Khadijah Ali Abdalrahman Hamad, Neveen A Kohaf
Annals of Medicine and Surgery May 1, 2025 DOI: 10.1097/MS9.0000000000003232 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Depression Ketamine Esketamine |
| Keywords | Ketamine therapy Mental health treatment Medical safety protocols Pain management Anesthesia advances |
| Citations | 7 |
| Key findings | Ketamine's safety profile involves cardiovascular, neuropsychiatric, and dependency risks, and evidence-based guidelines for administration and monitoring are needed. |
Abstract
Ketamine, a dissociative anesthetic, has gained widespread use in various medical contexts, including anesthesia, pain management, and treatment-resistant depression. Despite its therapeutic potential, concerns regarding its safety profile have prompted ongoing research and regulatory guidance. This comprehensive literature review explores the current safety considerations of ketamine, summarizing its adverse effects, particularly on cardiovascular, neuropsychiatric, and dependency effects. Evidence-based guidelines for its administration, dosing, and monitoring are discussed, emphasizing the importance of risk-benefit assessments in clinical practice. The review also delves into current guidelines and proposes future directions for ketamine research and clinical implementation, including enhanced safety protocols, long-term patient outcomes, and the development of individualized safe dosing protocols.
Comparable studies
Other narrative reviews on ketamine for depression, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine: a paradigm shift for depression research and treatment | 2019 | Review | |
| Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective | 2019 | Review | |
| Ketamine: A tale of two enantiomers | 2020 | Review | |
| Molecular mechanisms underlying the antidepressant actions of arketamine: beyond the NMDA receptor | 2021 | Review |
Citations in the library
Cited by 9
- Caution Is Warranted in Prescribing Ketamine for Mental Health. Journal of General Internal Medicine April 1, 2026
- Efficacy of Ketamine Infusion for Treatment of Opioid Use Disorder in Patients with Chronic Pain: a Narrative Review. Current Pain and Headache Reports December 15, 2025
- Psychedelics as a potential treatment for borderline personality disorder: A narrative review. Psychiatry Research July 1, 2026
- Ketamine in psychiatry: a systematic review of clinical applications, safety considerations, and emerging challenges Frontiers in Psychiatry October 1, 2026
- Treating addiction with an addictive drug: the ketamine paradox revisited Frontiers in Psychiatry July 9, 2026
and 4 more in the library
Cites 23
- Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study American Journal of Psychiatry May 21, 2019
- Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression JAMA Psychiatry December 27, 2017
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- The effect of a single dose of intravenous ketamine on suicidal ideation: a systematic review and individual participant data meta-analysis American Journal of Psychiatry October 3, 2017
- Ketamine use: a review Addiction July 21, 2011
and 18 more in the library