Severe Encephalatrophy and Related Disorders From Long-Term Ketamine Abuse: A Case Report and Literature Review

Abstract

Ketamine is a glutamate N-methyl D-aspartate receptor antagonist and an anaesthetic agent that has been effectively used to treat depression. However, ketamine has also been increasingly used for recreational purposes. The dissociative side-effects of ketamine use, such as hallucinations, are the reason for abuse. Additionally, long-term ketamine abuse has been highly associated with liver-gallbladder and urinary symptoms. The present study reports the case of a 28-year-old young male adult with an 8-year history of daily inhalation of ketamine. We investigated the association between ketamine abuse and the mechanism of its adverse effects, particularly encephalatrophy, and attempted to find a link between these disorders. These results would help us to better understand ketamine usage, ketamine abuse effects and the addictive mechanism. To the best of our knowledge, the present case is the first report of severe brain atrophy related to ketamine abuse. Details of the patient are presented and the mechanism of the encephalatropy-associated ketamine abuse is discussed. Furthermore, organ dysfunction following chronic ketamine abuse may indicate that the side effects are the result of comprehensive action on multiple regions in the brain.

Beyond therapeutic potential: a systematic investigation of ketamine misuse in patients with depressive disorders

“…Major depressive disorders are reported to be the ones with a lack of energy and persistently pessimistic behavior, along with complaints of anhedonia, agitation, and sleep issues [ 12 , 15 ]. Suicidal thoughts are also holding prominence in major depressive disorder [ 16 ].…”

“…Ketamine, a rapid-acting antidepressant, is sustained for up to 7 days in patients with TRD and suicidal patients. Its use was done sparingly for managing TRD and MDD or both, but due to abuse, addiction, and side effects, it has been minimized [ 15 ]. The formation of subcortical areas, such as the nucleus accumbens, which is linked to addiction behaviors, is influenced by the disruption of glutamate neurotransmission, which is connected to ketamine addiction.…”

Beyond Therapeutic Potential: A Systematic Investigation of Ketamine Misuse in Major Depressive Disorder Patients

“…Ketamine shows an antidepressant effect within hours that persist for days, maybe weeks, or beyond, which leads the patients to its addiction or abuse with the appearance of withdrawal symptoms by cessation of ketamine treatment. Misuse of ketamine leads to side effects of various signi cance ranging from mild to severe such as mood changes, agitation, and prolonged abuse can cause liver and brain dysfunction like in Liu et al [17].…”

Non-Opioid Anesthetics Addiction: A Review of Current Situation and Mechanism

“…From the 1990s to the beginning of the 21st century, ketamine accounted for approximately 2% of the drugs abused among American anesthesiologists, and it was placed into Schedule III of Schedules of Controlled Substances by the US Drug Enforcement Administration [ 19 , 20 ]. Long-term ketamine use can cause permanent damage to the brain, as well as negative effects on the urinary, cardiovascular, and digestive systems [ 21 , 22 , 23 , 24 ].…”