Ketamine: from prescription anaesthetic to New Psychoactive Substance.
M. R. Varı̀, G. Ricci, Marco Cavallo, Simona Pichini, A. Sirignano, Silvia Graziano
Current Pharmaceutical Design May 10, 2022 DOI: 10.2174/1381612828666220510115209 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Esketamine Ketamine |
| Key findings | The authors describe ketamine's trajectory from anaesthetic to recreational drug, noting its lower cost than MDMA, lack of respiratory depression at recreational doses, and legal availability as factors in its spread. They report that acute intoxication and deaths have been linked to exclusive ketamine use, and that the illicit market has grown markedly since 2015, with a significant increase in seizures and clinical cases worldwide. |
Abstract
Discovered in the United States of America (USA) in the 1960s, ketamine was introduced as an anaesthetic drug to specifically replace phencyclidine. Briefly, the substance moved from the medical world to recreational users, since it was discovered that intense psychedelic experiences were obtained with dosages lower than those prescribed for anesthesia. At the end of the 90's, circulated in London nightclubs as a drug itself and as counterfeit 3,4-methylenedioxymethamphetamine tablets. In 1997, the Drug Enforcement Administration (DEA) alerted the United States (US) government to the increasing diffusion of ketamine in American 'clubs', and in 1999, the substance was added to Schedule III of drugs controlled by federal authorities. In 2002, ketamine epidemics moved to Europe, and the European Monitoring Centre for Drugs and Drug Addiction carried out a risk assessment monitoring of the phenomenon. An estimated ninety-nine percent of all global ketamine seizures occurred in Asia. Its growing popularity is due to the fact that this new psychoactive substance is cheaper than other stimulants such as MDMA that the amount used for recreational purposes does not cause respiratory depression and its legal use as a drug makes it widely available for a diversion towards illicit markets. Nevertheless, acute intoxication and several deaths have been related to exclusive ketamine use both in Europe and internationally. Since 2015, there has been and increasing rise of the illicit ketamine market and currently the drug is being used with unprecedented peaks and a consequent significant increase in seizures and clinical cases worldwide.
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 3
- Is there a risk of esketamine misuse in clinical practice? Therapeutic advances in drug safety 2025
- Ketamine - precursor of a new generation antidepressant drugs Farmacja Polska April 17, 2024
- Psychoactive and Neurobiological Effects of Ketamine in Humans: A Scoping Review of Clinical Evidence. Journal of Clinical Medicine July 29, 2026
Cites 11
- Ketamine use: a review Addiction July 21, 2011
- Taming the Ketamine Tiger Anesthesiology August 6, 2010
- To use or not to use: an update on licit and illicit ketamine use Substance Abuse and Rehabilitation March 1, 2011
- 5-Year Trends in Use of Hallucinogens and Other Adjunct Drugs among UK Dance Drug Users European Addiction Research December 18, 2006
- The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Recommendations for the Use of Racemic Ketamine in Adults with Major Depressive Disorder: Recommandations Du Groupe De Travail Du Réseau Canadien Pour Les Traitements De L’humeur Et De L’anxiété (Canmat) Concernant L’utilisation De La Kétamine Racémique Chez Les Adultes Souffrant De Trouble Dépressif Majeur The Canadian Journal of Psychiatry November 11, 2020
and 6 more in the library