Ketamine in palliative care: an updated systematic review
Kinga Dowierciał, Joanna Wziątek, Piotr Kowalik, Daria Anna Krzyżanowska, Patrycja Fatyga, Wiktoria Fatyga, Gabriela Pabis, Paula Bętkowska, Iwona Koziołek, Magdalena Strzelczyk
Quality in Sport July 8, 2025 DOI: 10.12775/qs.2025.43.61429 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | End-of-life distress Esketamine Ketamine |
| Citations | 2 |
| Key findings | The authors conclude that evidence suggests ketamine can be effective for refractory pain (enabling lower opioid doses even in severe pain), depression, anxiety disorders, opioid tolerance, and opioid-induced hyperalgesia, positioning it as a promising palliative care agent. They note its rapid onset, multiple administration routes, and favorable safety profile at subanesthetic doses, but stress that long-term studies are needed to identify benefits and risks. |
Abstract
Introduction Ketamine is a well-known anesthetic and analgesic agent which primarily works through N-methyl-D-aspartate (NMDA) receptor antagonism, offering powerful analgesic effects that is particularly useful in opioid-refractory pain. Beyond pain control, it garnered significant attention in depression and anxiety research, which are some of the most frequent and serious symptoms experienced by patients in need of palliative care. This article provides an overview of Ketamine therapeutic applications in treatment of depression, anxiety, physical pain, opioid tolerance and opioid-induced hyperalgesia (OIH), drawing on research from PubMed published between 2020 and 2025. Aim of study This review aims to present the current state of knowledge regarding Ketamine, focusing on its pharmacological properties, clinical applications, and potential role in palliative care. Material and methods The review was based on research of articles published from 2020 to 2025 on the PubMed database. Keywords used in research were among others: Ketamine, palliative care, pain, neuropathic pain, depression. Current state of knowledge Ketamine plays important role in anesthesiology and it shows a lot of potential in psychiatry. Multifactoral effects result from complex mechanism of action. Evidence suggests Ketamine can be effective in managing refractory pain (enabling lower doses of opioids even in severe pain), depression and anxiety disorders, opioid tolerance and OIH, positioning ketamine as a promising agent for palliative care. Summary (conclusions) Ketamine's advantages such as its rapid onset, wide range applications, favorable safety profile at subanesthetic doses and many routes of administration make it a valuable tool in the end-of-life care. However long term studies are crucial for identifying both benefits and possible risks.
Comparable studies
Other narrative reviews on end-of-life distress, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Top Ten Tips Palliative Care Clinicians Should Know About Psychedelic-Assisted Therapy in the Context of Serious Illness. Palliative care clinicians and patients | 2022 | Review | |
| The Potential of Psychedelics for End of Life and Palliative Care. Patients with life-threatening diagnoses | 2022 | Review | |
| Psilocybin in Palliative Care: An Update. Palliative care patients | 2023 | Review | |
| Psychedelic medicines for end-of-life care: Pipeline clinical trial review 2022. People with terminal illnesses experiencing depression, anxiety, or existential distress | 2023 | Scoping review | n = 25 |
| Psilocybin-assisted psychotherapy for existential distress: practical considerations for therapeutic application—a review | 2024 | Narrative review |
Citations in the library
Cites 7
- A Phase II, Open-Label Clinical Trial of Intranasal Ketamine for Depression in Patients with Cancer Receiving Palliative Care (INKeD-PC Study) Cancers January 7, 2023
- Ketamine and Ketamine-Assisted Psychotherapy for Psychiatric and Existential Distress in Patients with Serious Medical Illness: A Narrative Review. Journal of Palliative Medicine January 22, 2025
- Use of ketamine for depression and suicidality in cancer and terminal patients: Review of current data AIMS Public Health 2023
- Ketamine Use for Palliative Care in the Austere Environment: Is Ketamine the Path Forward for Palliative Care. The American journal of hospice & palliative care March 1, 2025
- Ketamine subcutaneous continuous infusion for depressive symptoms at home: A case report beyond pain use. Palliative & Supportive Care October 1, 2024
and 2 more in the library