Ketamine Use Disorder and Entrenchment of Delusional Beliefs: A Case Report.
Samuel Sukmin Yang, Rachel Goud, Jeremy Weleff
Journal of Addiction Medicine October 5, 2026 DOI: 10.1097/adm.0000000000001788 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 36-year-old man with chronic heavy ketamine use and alcohol use disorder |
| Duration | 2 years of heavy, chronic ketamine use |
| Topics | Ketamine Esketamine |
| Keywords | Delusions Ketamine use disorder Psychosis |
| Key findings | The authors report that a 36-year-old man with two years of heavy ketamine use developed persistent grandiose and hyper-religious delusional beliefs that remained delusional in intensity despite limited functional impact, alongside medical complications, and met DSM-5-TR criteria for ketamine use disorder. They argue that evidence on treating ketamine use disorder and related psychotic symptoms is limited and that standardized treatment guidelines are needed. |
Abstract
Ketamine has gained increasing attention for its therapeutic potential, yet concerns remain regarding its misuse and the associated complications of its use. Ketamine use and ketamine use disorder can induce psychotic symptoms, but the persistence of such symptoms with chronic use and effective treatment of these symptoms is poorly characterized. Although case reports of ketamine use and medical and psychiatric consequences exist in the literature, there is limited evidence regarding the treatment of ketamine use disorder (KUD). We present the case of a 36-year-old man who developed persistent delusional beliefs and medical complications over 2 years of heavy, chronic ketamine use. In the absence of any prior psychiatric diagnoses other than alcohol use disorder, he met DSM-5-TR criteria for KUD. His beliefs were primarily grandiose and hyper-religious in content, incorporating fringe online content. Although there was a limited impact on his functioning, his beliefs were maintained in delusional intensity. Written informed consent was obtained from the patient. This case report illustrates a manifestation of enduring delusional beliefs in the setting of chronic ketamine use and other important medical sequelae of its use. Limited literature exists concerning the treatment of ketamine use disorder or related psychotic symptoms, and there is a need for standardized treatment guidelines so interventions may be provided promptly to prevent serious psychiatric and medical complications.
Comparable studies
Other case reports and case series on ketamine, most cited first.
Citations in the library
Cites 8
- Reviewing the ketamine model for schizophrenia Journal of Psychopharmacology November 20, 2013
- Association of Ketamine With Psychiatric Symptoms and Implications for Its Therapeutic Use and for Understanding Schizophrenia JAMA Network Open May 1, 2020
- Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia Journal of Psychiatric Research December 24, 2014
- Intensive ketamine use for multiple years: A case report. American Journal on Addictions 2015
- The landscape of ketamine use disorder: Patient experiences and perspectives on current treatment options. Addiction April 28, 2025
and 3 more in the library