Ketamine in insulin resistance: Pharmacokinetics, cardiovascular implications and cellular effects on cardiomyocytes.
Ariana Ramirez, Stephanie Howes, Robert Chilton
Diabetes, Obesity & Metabolism May 1, 2025 DOI: 10.1111/dom.16248 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Population | Patients with insulin resistance |
| Topics | Ketamine Esketamine |
| Keywords | Cardiovascular disease Diabetes complications Drug mechanism Insulin resistance Pharmacokinetics Ketamine pharmacology Cardiovascular effects Metabolic disorders Drug-disease interactions |
| Citations | 3 |
| Key findings | In patients with insulin resistance, ketamine's effects on glucose metabolism, mitochondrial function, and oxidative stress are exacerbated, emphasizing the need for careful administration and monitoring. |
Abstract
Ketamine, a dissociative anaesthetic, has expanded its clinical use beyond anaesthesia to pain management and treatment-resistant depression. As an N-methyl-d-aspartate receptor antagonist, ketamine disrupts the excitatory neurotransmission via interaction with the opioid, alpha-amino-3-hydroxy-5-methyl-4-isooxazole-propionic acid receptor and serotonin pathways, contributing to its broad therapeutic potential. However, its use is not without risks. In patients with insulin resistance, ketamine's effect on glucose metabolism, mitochondrial function and oxidative stress are exacerbated. This paper explores ketamine's pharmacokinetics, cardiovascular impact and its cellular effects on cardiomyocytes, particularly in insulin-resistant individuals. The findings discussed emphasize the importance of careful administration and monitoring in these vulnerable populations to balance ketamine's therapeutic benefits against its potential risks in patients with underlying metabolic or cardiovascular conditions.
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
Cites 5
- Ketamine: NMDA Receptors and Beyond Journal of Neuroscience November 2, 2016
- A unified model of ketamine's dissociative and psychedelic properties. Journal of Psychopharmacology December 17, 2022
- Repurposing Ketamine in the Therapy of Depression and Depression-Related Disorders: Recent Advances and Future Potential. Aging and disease April 29, 2024
- The role of adipokines in the rapid antidepressant effects of ketamine. Molecular Psychiatry January 2017
- Pharmacological properties of ketamine. Drug and Alcohol Review June 1, 1996