Chronic pain and opioid use disorder (OUD) are highly prevalent and frequently co-occurring conditions that pose complex treatment challenges. While opioids are effective for pain management, prolonged use significantly enhances risk of developing substance dependence. Conversely, addiction-focused therapies often fail to relieve persistent somatic pain. Ketamine, an N-methyl-D-aspartate (NMDA)...
Pre-attentive information processing deficits are associated with poor outcomes in schizophrenia. The auditory mismatch negativity (MMN), observed when an auditory signal changes, is reduced in schizophrenia, related to glutamatergic dysfunction and is considered a response biomarker. We hypothesized that glycine, an N-methyl-d-aspartate receptor (NMDAR) coagonist, could reverse the...
Esketamine and ketamine are perioperative analgesics and anesthetics that have been widely adopted in clinical practice in Europe and the United States. However, their application in China remains in the early stages of exploration and implementation. Esketamine and ketamine exert their effects through multiple receptors and pathways, but primarily act through non-competitive antagonism of the...
Oral esketamine is a promising new therapy for treatment-resistant depression. However, concerns exist about interindividual pharmacokinetic variability. Genetic polymorphisms regulating the expression of ATP-binding cassette (ABC) transporters might influence bioavailability. Utilizing blood samples from a placebo-controlled trial investigating repeated, low dose oral esketamine (N = 18), we...
Since the introduction of the NMDA receptor antagonist (S)-ketamine for depression therapy, it has become evident that the glutamatergic hypothesis of depression, proposed over 20 years ago, was justified and based on solid foundations. A significant breakthrough with this drug is its ability to produce a rapid and relatively long-lasting antidepressant effect in patients who are resistant to...
Ketamine has emerged as a rapid-acting intervention for treatment-resistant psychiatric disorders, generating both enthusiasm and unease. While evidence demonstrates robust antidepressant, anxiolytic and anti-suicidal effects, ketamine also carries risks, including dissociation, dependence and uncertain long-term safety. Its reputation as a recreational drug further complicates clinical...
Ketamine’s development in psychiatry exemplifies the evolution of psychopharmacology over six decades. Originally introduced as a dissociative anesthetic and psychotomimetic probe, ketamine has been repositioned as a rapidly acting antidepressant, particularly for treatment-resistant depression (TRD). This narrative review draws on historical sources, clinical trials, regulatory documents, and...
Objective: To compare acceptability and effectiveness of psilocybin, ketamine and commonly prescribed antidepressants in the management of Major Depressive Disorder (MDD). Methods: This is a systematic review with network meta-analysis. The survey was conducted between January and June 2023, employing MEDLINE, PsyINFO, Embase, Web of Science and ClinicalTrials.gov databases. Randomized...
Individuals with eating disorders (EDs) have an increased risk of treatment resistant depression (TRD) and treatment resistant bipolar disorder (TRBD) and a higher rate of suicidal ideation and death by suicide than individuals without EDs. Individuals with EDs are less responsive to conventional treatments for mood disorders than individuals without EDs. Ketamine has evidence for treatment of...
The present work aims to analyze the role of pharmaceutical care in the therapeutic use of ketamine, considering its clinical applications, risks, and benefits. This is a bibliographic review research carried out using the PubMed and Scielo databases, as well as books from the health sector library. The analysis focused on the anesthetic ketamine, its indications, side effects, improper...
Ketamine may be a viable treatment option for patients with treatment-resistant post-stroke depression. Further research is warranted to better understand the efficacy and safety of ketamine in this specific patient population.
Psychiatry ResearchDecember 1, 2025Ahmed Z Elmaadawi, Imane Naha, Shruti Prabhudesai et al.2 citations
Treatment-resistant depression (TRD) poses significant clinical challenges, often necessitating alternative treatments such as intravenous (IV) ketamine or intranasal esketamine. This study compared the effectiveness of these modalities and examined predictors of treatment response, including comorbidity profile, prior antidepressant failures, age, and gender. A retrospective chart review was...
ABSTRACT Introduction Posttraumatic stress disorder (PTSD) is a mental disorder resulting from exposure to traumatic events. Evidence suggests that ketamine may be efficacious in treating PTSD, however, ketamine's mechanisms in treating PTSD remain unclear. Herein, this review aims to evaluate the clinical outcomes of ketamine treatment in persons with PTSD and investigate the possible...
As a therapy for postoperative analgesia, esketamine shows relatively favorable efficacy in pain control and is associated with a lower risk of postpartum depression. However, this result is unstable. Furthermore, esketamine may increase the risk of dizziness in pregnant women aged over 30 years. Since all the experiments in this study are conducted in China, there are certain regional...
ABSTRACT: Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been approved for use as a clinical and veterinary anesthetic since 1970. Although esketamine, a specific molecular form of ketamine, is FDA-approved for the management of treatment-resistant depression, regular ketamine is often used off-label at subanesthetic doses to treat depression as well as other...
CureusDecember 1, 2025Demetra Solomos, Aggeliki Bairaktari, Theodoros Xanthos et al.
Introduction Axillary brachial plexus block is a widely used regional anesthesia technique for below-elbow surgeries. The use of adjuvant medications can influence block characteristics and postoperative pain experience. This randomized, prospective, single-blind comparative study aimed to evaluate whether ketamine, administered intravenously or regionally with ropivacaine, affects...
CureusDecember 1, 2025Kamran Nazir, Waqas Ahmed, Salman Rafi et al.
Ketamine-induced cholangiopathy (KIC) is a rare but increasingly recognized manifestation of chronic ketamine toxicity, often accompanied by urinary tract injury such as hemorrhagic cystitis. We report the case of a 55-year-old female with recurrent hemorrhagic cystitis and a long-standing history of intermittent recreational ketamine use who presented with asymptomatic cholestatic liver enzyme...
NursingDecember 1, 2025Rebecca Ann Ivory, Kathryn M. Pate, Brentyn M Jones et al.
Major depressive disorder (MDD) affects approximately 332 million people worldwide. Among those diagnosed with MDD, approximately 53% receive pharmacologic treatment, such as ketamine. Nurses must be knowledgeable about ketamine and other emerging, effective behavioral health therapies used to treat chronically depressed mood and acute suicidal ideation. This article outlines the best nursing...
Repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are effective treatment options for treatment-resistant depression (TRD) that have not been directly compared. We aimed to compare the effectiveness of rTMS, intranasal esketamine, and pharmacotherapy for TRD using data from two randomised clinical trials (RCTs). This secondary analysis of individual patient data...
Suicidality is a transdiagnostic entity in patients with and without psychiatric disorders. Ketamine is a novel treatment for treatment-resistant depression with favorable effects on related suicidality in this population. Little is known about the effects of ketamine on suicidality as a distinct phenomenon. To assess whether a dose of 75 mg intranasal (IN) ketamine reduces acute suicidality...