The diverse effects of ketamine, jack-of-all-trades: a narrative review.
Nicholas D Richards, Simon J Howell, Mark C Bellamy, James Beck
British Journal of Anaesthesia March 1, 2025 DOI: 10.1016/j.bja.2024.11.018 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Ketamine Esketamine |
| Keywords | Nmda receptor antagonist Anaesthesia Anti-inflammatory properties Antidepressant effects Sedation Tumour suppression Ketamine medicine Glutamate antagonists Therapeutic uses Pain management analgesia Pain relief |
| Citations | 20 |
| Key findings | Ketamine has diverse therapeutic potentials including anaesthesia, sedation, analgesia, bronchodilation, anti-inflammatory effects, tumour inhibition, and antidepressant properties, warranting further research across multiple specialty areas. |
Abstract
Ketamine, an N-methyl-D-aspartic acid receptor antagonist that was first discovered in 1962, has become established in anaesthesia providing dose-dependent anaesthetic, sedative, and analgesic effects. Ketamine, however, also acts on a wide range of other cellular targets, resulting in interesting and diverse effects on both physiological and pathological processes. Potential beneficial properties of ketamine include cardiovascular stability for patients undergoing sedation or anaesthesia, analgesia in both acute and chronic pain, bronchodilation in severe refractory asthma, anti-inflammatory properties particularly in sepsis, tumour inhibition, and antidepressant properties with marked ability to reverse suicidal ideation. The reluctance to adopt ketamine into routine practice is likely attributable in part to the stigma and negative reputation associated with its perceived side-effects and potential for abuse. This review explores the diverse properties and therapeutic potentials of ketamine being investigated across different fields whilst also identifying areas for ongoing and future research. Given the diverse range of potential benefits and promising early work, ketamine should be the focus of ongoing research in multiple different specialty areas. This includes areas relevant to anaesthesia and perioperative medicine, such as acute and chronic pain management, ICU sedation, and even tumour suppression in those undergoing surgical resection of malignancies.
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 8
- The Nine Lives of Ketamine: From CI-581 to Present Day Clinical Application-Commentary on Domino et al. Clinical Pharmacology & Therapeutics June 1, 2025
- Comparable Acute Antidepressant-like Effects of Two Subanesthetic Ketamine Doses Are Associated with Divergent Region-Specific Molecular Responses After Adolescent Chronic Stress International Journal of Molecular Sciences October 15, 2026
- Effect of intraoperative esketamine on moderate-to-severe depressive symptoms in major surgery patients: A randomized clinical trial. Pharmacological Research July 1, 2026
- Increased morning cortisol after ketamine treatment for suicidal depression: Exploratory report from a randomized trial. Journal of Affective Disorders June 25, 2026
- Comparative EEG analysis of the effects of ketamine enantiomers and metabolites in rhesus macaques. Journal of Neurophysiology April 1, 2026
and 3 more in the library
Cites 27
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) CNS Neuroscience & Therapeutics April 10, 2013
- 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 for chronic pain: risks and benefits British Journal of Clinical Pharmacology February 21, 2013
- The destruction of the lower urinary tract by ketamine abuse: a new syndrome? British Journal of Urology August 1, 2008
and 22 more in the library