Characterization of Oral Ketamine Use: A Retrospective Review.
Miranda Hetrick, Emily Casey, Jacob Radcliff, Tanya Uritsky
Journal of Pain & Palliative Care Pharmacotherapy March 1, 2025 DOI: 10.1080/15360288.2024.2401979 (opens in new tab)
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Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective cohort study Peer reviewed |
|---|---|
| Population | Hospitalized patients aged 18 years or older receiving oral ketamine |
| Intervention | Oral ketamine |
| Dose | 1 mg/kg/day median starting dose, 1.6 mg/kg/day median maximum dose |
| Topics | Addiction Ketamine Esketamine |
| Keywords | Oral ketamine Pain management Ketamine therapy Opioid alternatives Chronic pain treatment Drug tolerance |
| Citations | 2 |
| Key findings | Oral ketamine was administered safely for analgesia with a low incidence of safety events, and median oral morphine equivalent doses decreased during therapy. |
Abstract
Ketamine is an N-methyl D-aspartate (NMDA) receptor antagonist used to treat pain at subanesthetic doses. Ketamine is beneficial for pain control in patients who have a high tolerance to opioids and are experiencing opioid-induced hyperalgesia. This study characterizes oral ketamine use for analgesia at a large academic hospital and reports safety outcomes for hospitalized patients. This study was a retrospective electronic health record (EHR) review of patients ≥ 18 years or older receiving oral ketamine. The primary endpoint was median ketamine starting dose and maximum dose (mg/kg/day) during treatment duration. Secondary outcomes included oral Morphine Milligram Equivalents (MMEs), buprenorphine dose, minimum and maximum pain scores on the first and last day of therapy. Safety endpoints were reported. The median starting dose was 1 mg/kg/day, and the median maximum dose was 1.6 mg/kg/day. Median MMEs decreased from the first day to the last day of oral ketamine therapy. The study population experienced a low incidence of safety events overall. Oral ketamine was administered safely for analgesia, with patients receiving ketamine doses that were on the lower end of the established therapeutic range. Evaluation of the efficacy and safety of oral ketamine use for analgesia should be further studied.
Comparable studies
Other observational and cohort studies on ketamine for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Brain damages in ketamine addicts as revealed by magnetic resonance imaging Ketamine addicts | 2014 | Observational cohort | n = 21 |
| Maintenance Intramuscular Ketamine-Assisted Psychotherapy, a Retrospective Chart Review of Efficacy, Adverse Events, and Dropouts from a Community Practice. Patients receiving intramuscular ketamine with contemporaneous psychotherapy for... | 2024 | Observational study | n = 70 |
| Prescribing bias and adverse outcomes of esketamine in major depression comorbid substance. Adults aged 18 years or older with major depressive disorder in the TriNetX US... | 2026 | Retrospective cohort study | n = 30,670 |
| Ketamine Therapy for Chronic Pain Provides Added Benefits for Substance Misuse Therapy Adult chronic pain patients with comorbid substance misuse | 2026 | Observational study | n = 20 |
| Associations between psychedelic use and adverse outcomes in substance use disorders: a real-world EHR-based cohort study. U.S. patients aged 12 years and older with a documented substance use disorder... | 2025 | Retrospective cohort study | n = 3,209,798 |