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To use or not to use: an update on licit and illicit ketamine use

Jih-Heng Li, Vickna Kasinather, Cheung, Zhou, Nurhidayat, Des Jarlais, Richard Schottenfeld

Substance Abuse and Rehabilitation March 1, 2011 DOI: 10.2147/sar.s15458 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics Ketamine Esketamine
Keywords Street drugs Pharmacology Medical emergency
Citations 146
Key findings Ketamine's dangers, including dependence, urinary tract dysfunction, and potential for harm, may have been underestimated, while recent findings suggest it could be useful for treating major depressive disorder.

Abstract

Ketamine, a derivative of phencyclidine that was developed in the 1960s, is an anesthetic and analgesic with hallucinogenic effects. In this paper, the pharmacological and toxicological effects of ketamine are briefly reviewed. Ketamine possesses a wide safety margin but such a therapeutic benefit is somewhat offset by its emergence phenomenon (mind-body dissociation and delirium) and hallucinogenic effects. The increasing abuse of ketamine, initially predominantly in recreational scenes to experience a "k-hole" and other hallucinatory effects but more recently also as a drug abused during the workday or at home, has further pushed governments to confine its usage in many countries. Recently, urinary tract dysfunction has been associated with long-term ketamine use. In some long-term ketamine users, such damage can be irreversible and could result in renal failure and dialysis. Although ketamine has not yet been scheduled in the United Nations Conventions, previous studies using different assessment parameters to score the overall harms of drugs indicated that ketamine may cause more harm than some of the United Nations scheduled drugs. Some countries in Southeast and East Asia have reported an escalating situation of ketamine abuse. Dependence, lower urinary tract dysfunction, and sexual impulse or violence were the most notable among the ketamine-associated symptoms in these countries. These results implied that the danger of ketamine may have been underestimated previously. Therefore, the severity levels of the ketamine-associated problems should be scrutinized more carefully and objectively. To prevent ketamine from being improperly used and evolving into an epidemic, a thorough survey on the prevalence and characteristics of illicit ketamine use is imperative so that suitable policy and measures can be taken. On the other hand, recent findings that ketamine could be useful for treating major depressive disorder has given this old drug a new impetus. If ketamine is indeed a remedy for treating depression, more research on the risks and benefits of its clinical use will be indispensable.

Comparable studies

Other narrative reviews on ketamine, most cited first.

Study Year Design Participants
Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms 2018 Review
Mechanisms of Ketamine Action as an Antidepressant 2018 Review
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 Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) 2013 Review
A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders 2017 Review and consensus statement

Citations in the library

Cited by 41

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Ketamine Esketamine Addiction Depression Meditation Mystical experience