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Urological symptoms following ketamine treatment for psychiatric disorders: A systematic review.

Jess Kerr-Gaffney, Anna Tröger, Alice Caulfield, Philipp Ritter, James Rucker, Allan H. Young

Journal of Psychopharmacology June 30, 2025 DOI: 10.1177/02698811251350267 (opens in new tab)

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AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Sample size 27
Population Adults receiving ketamine treatment for psychiatric disorders
Intervention Ketamine
Topics Depression Ketamine Esketamine
Keywords Adverse event Ketamine safety ketamine Therapeutic ketamine Largely unfounded concerns Urological health bladder Bladder issues Bladder symptoms Overall urinary function Urology-related Urological risks Psychiatric applications ketamine Psychiatric conditions
Citations 6
Key findings Therapeutic ketamine treatment does not appear to be associated with an elevated risk of urological symptoms, though most studies were short-term and lacked systematic monitoring.

Abstract

Ketamine has emerged as a putative rapid-acting treatment option for psychiatric disorders, particularly treatment-resistant depression. Chronic recreational ketamine use is associated with ketamine-induced urological toxicity, raising concerns over the safety of repeated ketamine treatments. This systematic review aimed to synthesise urological findings from clinical trials and observational studies using ketamine for the treatment of psychiatric disorders. Electronic databases were searched up until 4th April 2024 for trials and observational studies using ketamine treatment for psychiatric disorders in adults, and which reported assessment of urinary, bladder or renal symptoms. Twenty-seven studies were included, mostly in depressive disorders (N = 24). Urological symptoms were reported in 0%-24.5% of patients receiving ketamine treatment; symptoms tended to be mild or moderate in severity. Where reported, continuous outcome measures (urinary parameters and symptom questionnaires) did not show significant changes from baseline to follow-up. Only 15% of studies were rated low risk of bias. Most studies did not assess long-term ketamine treatment, and many included undefined or passive monitoring of urological symptoms rather than systematic assessment. Based on the limited data available, ketamine treatment does not appear to be associated with elevated risk of urological symptoms; however, further long-term studies are required.

Comparable studies

Other systematic reviews and meta-analyses on ketamine for depression, most cited first.

Study Year Design Participants
Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression Participants with major depression in placebo-controlled, double-blind, randomized... 2015 Systematic review and meta-analysis
Side-effects associated with ketamine use in depression: a systematic review. Patients with depression 2018 Systematic review
Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis Adults with unipolar or bipolar major depression 2020 Systematic review and meta-analysis n = 1,877
Single-dose infusion ketamine and non-ketamine N-methyl-D-aspartate receptor antagonists for unipolar and bipolar depression: a meta-analysis of efficacy, safety and time trajectories Patients with major depressive disorder or bipolar depression 2016 Systematic review and meta-analysis n = 588
The use of ketamine as an antidepressant: a systematic review and meta‐analysis People with major depressive disorder or bipolar disorder receiving ketamine infusion 2015 Meta-analysis n = 437

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Depression Ketamine Esketamine

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