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Ketamine renaissance: Expanding horizons from anesthesia to depression and pain

Raja Suhail Shounthoo, Ajaiz Rasool, Athar Un Nisa Quraishi, Humaira Bashir, Falak Ara, Ishrat Yousuf

Asian Journal of Medical Sciences June 30, 2026 DOI: 10.71152/ajms.v17i7.5333 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Population Review of ketamine literature across anesthesia, psychiatry, and pain medicine
Topics Ketamine Neuroplasticity Depression Esketamine
Keywords Monoaminergic Dissociative Depression economics Antidepressant Perioperative Glutamatergic Anesthesia Chronic pain Anesthetic agent Intensive care medicine Midazolam Acute pain
Key findings Ketamine offers rapid antidepressant effects in treatment-resistant depression and efficacy in acute and chronic pain, but long-term safety, protocol standardization, and misuse potential remain unresolved.

Abstract

Ketamine, a dissociative anesthetic introduced in the 1960s, has re-emerged as a versatile therapeutic agent extending beyond its traditional perioperative role. Its rapid antidepressant action in treatment-resistant depression and efficacy in acute and chronic pain syndromes have driven what is termed the “ketamine renaissance.” Unlike conventional monoaminergic antidepressants, ketamine primarily modulates glutamatergic neurotransmission, enhancing synaptic plasticity and influencing neuroinflammatory pathways. This review critically evaluates ketamine’s evolving role across anaesthesia, psychiatry, and pain medicine, highlighting mechanistic insights, clinical applications, safety concerns, and current evidence gaps. While ketamine offers significant therapeutic promise, issues related to long-term safety, standardization of protocols, and misuse potential remain unresolved.

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