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Ketamine addiction following a single sub-anaesthetic ketamine treatment for acute suicidality in a psychiatrically multimorbid patient: case report

Gijsbrecht H. J. Roelandt, Jurriaan F M Strous, Jeanine Kamphuis, Robert A Schoevers, Radboud M Marijnissen

BJPsych Open May 1, 2026 DOI: 10.1192/bjo.2026.11012 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case report Pilot study Peer reviewed
Sample size 1
Population A 25-year-old woman with depression, obsessive–compulsive disorder, autism spectrum disorder, and anorexia nervosa
Intervention Intranasal ketamine
Dose sub-anaesthetic dose
Topics Addiction Esketamine Ketamine
Key findings A single sub-anaesthetic dose of intranasal ketamine was followed by the development of ketamine addiction, with subsequent polysubstance abuse and significant psychosocial impairment. The authors propose that ketamine's addictive potential warrants careful screening and monitoring in psychiatric use.

Abstract

Summary This case report presents the case of a 25-year-old woman who developed ketamine addiction following a single sub-anaesthetic dose of intranasal ketamine in a pilot study investigating intranasal racemic ketamine for acute suicidality. She had a history of depression, obsessive–compulsive disorder, autism spectrum disorder and anorexia nervosa, and she had sporadically used alcohol and cannabis. Following the intervention, she reported a transient reduction in suicidal ideation but later sought illicit ketamine to recreate its calming effects on intrusive thoughts. Subsequently she also started abusing cocaine and 3-methylmethcathinone (3-MMC). Within weeks she had escalated to daily use, which led to financial distress, housing instability and a suicide attempt when access was cut off. Although she initially ceased use, she later relapsed into ketamine and cocaine addiction. This case highlights the addictive risk of ketamine, even in controlled settings. Given ketamine’s rising use in psychiatric treatment, careful screening, monitoring and awareness of addiction potential are essential. Future research should evaluate patient-specific risk factors and dosing strategies to minimise abuse liability.

Comparable studies

Other case reports and case series on ketamine for addiction, most cited first.

Study Year Design Participants
Ketamine Dependence in an Anesthesiologist: An Occupational Hazard? Anesthesiologist from India 2014 Case study n = 1
Qualitative analysis of a patient's experience of ketamine-assisted psychotherapy for substance use disorder: Empirical synergies with twelve-step programs 28-year-old female treated for alcohol and opioid use disorder 2025 Case study n = 1
Intravenous ketamine for severe alcohol use disorder at Moi Teaching & Referral Hospital, Kenya: a case report A 39-year-old African male with severe alcohol use disorder, comorbid tobacco use... 2023 Case study n = 1
Grayken lessons: a multidisciplinary approach to care for a patient with severe ketamine use disorder. Young woman with severe ketamine use disorder and PTSD 2026 Case study n = 1
Intensive ketamine use for multiple years: A case report Patient with bipolar I disorder and history of substance dependence 2014 Case study n = 1

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