Ketamine abuse potential and use disorder

Abstract

Ketamine is a noncompetitive antagonist of N-methyl-d-asparate (NMDA) receptor and has been long used as an anesthetic agent in humans and veterinary medicine. The present article reviews the epidemiology, pharmacology, neurochemistry, and treatment of ketamine abuse. Ketamine has a unique mood controlling property and a number of studies have demonstrated a significant and rapid antidepressant effect of ketamine. However, the therapeutic value of ketamine to treat psychiatric disorders faces a major challenge that ketamine also owns significant reinforcing and toxic effects. Its abuse has posted severe harms on individuals and society. Disrupted learning and memory processing has long been related with ketamine use. It is hypothesized that ketamine blocks NMDA receptors on gamma-aminobutyric acid (GABA) neurons inside the thalamic reticular nucleus, which leads to disinhibition of dopaminergic neurons and increased release of dopamine. Currently, there is no specific treatment for treating every ketamine patient presenting peripheral toxicity. Interestingly, ketamine psychotherapy has been suggested to be a promising approach to treat addiction of other drugs. Future research can continue to develop creative ways to investigate potential mechanism and treatments related to ketamine abuse that have posted severe individual and social harms.

Ketamine: 50 Years of Modulating the Mind

“…Higher doses induce more severe, schizophrenia-like symptoms and perceptions that are completely separate from reality (Wolff and Winstock, 2006; Niesters et al, 2014). Although these effects resolve approximately 2 h after acute ketamine use, long-term use can cause more pronounced and persistent neuropsychiatric symptoms, including schizophrenia-like symptoms, cognitive impairment and poor psychological well-being (Morgan et al, 2009, 2010; Liu et al, 2016). …”

What Is New about New Antidepressants?

“…Common adverse effects of ketamine include dizziness, neurotoxicity, cognitive dysfunction, blurred vision, psychosis, dissociation, restlessness, headache, nausea, vomiting, and cardiovascular and urological dysfunction [47, 53, 54]. Adverse effects tend to be brief in acute treatment with low doses, but they are more problematic at higher doses or over longer periods of administration [53].…”

Depression in chronic ketamine users: Sex differences and neural bases

“…Ketamine has powerful psychological effects and recent studies including many clinical trials have focused on its potential as an antidepressant. On the other hand, ketamine elicits euphoria and dissociation (“out-of-body” experiences) and has increasingly become one of the major substances of abuse in many parts of the world, including Asia (Huang et al, 2014; Jia et al, 2015; Liu et al, 2016; Sassano-Higgins et al, 2016; Singh et al, 2013; Tang et al, 2015). In animal studies, ketamine induces self-administration and conditioned place preference (Botanas et al, 2015; De Luca and Badiani, 2011; Guo et al, 2016a; Suzuki et al, 1999; van der Kam et al, 2009; Venniro et al, 2015; Winger et al, 2002; Young and Woods, 1981).…”