Upper gastrointestinal problems in inhalational ketamine abusers

Poon, Tai Lun; Wong, Ka Fai; Chan, Man Yee; Fung, Ka Wai Terence; Chu, Sau Kwan; Man, Chi‐Wai; Yiu, MK; Leung, Siu Kee

doi:10.1111/j.1751-2980.2010.00424.x

Cited by 69 publications

(36 citation statements)

References 2 publications

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“…However, the mechanism of this pathology remains unknown. In a retrospective study of 37 ketamine abusers for the upper gastrointestinal problems [11], 75.7 % of them had upper GI symptoms, which are comparable to our chronic cohort. Fifteen (40.5 %) and 9 (24.3 %) of them had elevated alanine aminotransferase (ALT) and alkaline phosphate (ALP), respectively, but the study was unable to demonstrate any association between epigastric pain and deranged ALT or ALP.…”

Section: Discussionsupporting

confidence: 80%

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Acute and Chronic Toxicity Pattern in Ketamine Abusers in Hong Kong

Chan

2012

J. Med. Toxicol.

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Ketamine has been the commonest abusive substance used by Hong Kong teenager since 2005. It is also the fourth commonest poison encountered in Hong Kong Poison Information Centre (HKPIC) poisoning data in 2010. From June 2008 to July 2011, HKPIC managed 188 and 96 cases of acute and chronic ketamine poisoning, respectively, which reflect its acute and chronic toxicity pattern. Demographically, there is a male predominance, and the majority is between the ages of 10-39. For the acute cases, 48 % presented with neurological features such as confusion, drowsiness, or transient loss of consciousness which usually subside with supportive care in a few hours. For the chronic cases, 92 % of them presented with features of ketamine cystitis while about 66 % presented with chronic abdominal pain. The current understanding of ketamine cystitis and chronic abdominal pain will be reviewed. Management is primarily symptomatic measures and most importantly abstinence from ketamine use.

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Section: Discussionsupporting

confidence: 80%

“…It was shown that the odd ratio of symptomatic relief of the abdominal pain is 12.5 (95 % CI 1.2-130) for those who stopped ketamine versus those who continued its use [11].…”

Section: Discussionmentioning

confidence: 99%

Acute and Chronic Toxicity Pattern in Ketamine Abusers in Hong Kong

Chan

2012

J. Med. Toxicol.

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“…The reported prevalence of upper gastrointestinal symptoms is up to 75% (2,12). Gastritis has been demonstrated in 85% of those who had endoscopy (12). Complete relief of the symptoms is observed in most cases when patients abstain from the drug.…”

Section: Discussionmentioning

confidence: 96%

“…Chronic abdominal pain is a common presenting complaint in ketamine abusers. The reported prevalence of upper gastrointestinal symptoms is up to 75% (2,12). Gastritis has been demonstrated in 85% of those who had endoscopy (12).…”

Section: Discussionmentioning

confidence: 99%

Multiorgan Dysfunction Related to Chronic Ketamine Abuse

Pappachan

Raj

Thomas

et al. 2014

Baylor University Medical Center Proceedings

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“…Serious lower urinary tracts symptoms (increased urinary frequency, urgency, incontinence, hematuria, and dysuria) [14][15][16], gastritis and liver and kidney dysfunction [16,17] are also common in this population. Psychiatric disorders are often comorbid by ketamine include depression, which is remarkably prevalent among chronic ketamine users [18,19], psychosis [18] and cognitive impairment [20][21][22].…”

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confidence: 99%

Ketamine Addiction

Liang¹,

Ungvári²,

Lee³

et al. 2018

Dual Diagn Open Acc

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EditorialKetamine was developed in 1962 as an anaesthetic agent [1] for use in pediatrics, oncology, and veterinary practice [2]. Ketamine primarily and non-competitively antagonizes NMDA (N-methyl-D-aspartate) receptors, thereby interfering with the excitatory amino acid transmission, which underlines its analgesic and dissociative effects [2]. Ketamine also has weak effects on opioid, muscarinic and monoamine receptors [1], enhances the neurotransmission of noradrenaline, serotonin and dopamine in a dose-dependent fashion, which, together with its effects on glutaminergic system, accounts for its psychotomimetic and sympathomimetic effects [2] and addiction potential [3].During the past decade, ketamine has been proven efficacious in treatment-resistant depression [4]. Due to its unique neurochemical profile, ketamine, and its analogue phencyclidine, has also been tried as a new treatments for psychosis [5] and addiction [6,7]. In contrast to increasing research efforts to understand ketamine's potential as a therapeutic agent, only a few studies focused on understanding ketamine addiction.Ketamine misuse started in the United States in the 1970s, soon after its development and wider availability [2]. Ketamine is still a commonly abused drug around the world [8], particularly in East Asia [9]. Ketamine is the second and third most commonly abused drug in Hong Kong [10] and in mainland China and Taiwan [9], respectively. Ketamine is predominantly consumed by young people [10,11], gay clubbers [12,13] and poly-substance users [8].Heavy ketamine users suffer from both physical and mental problems. Serious lower urinary tracts symptoms (increased urinary frequency, urgency, incontinence, hematuria, and dysuria) [14][15][16], gastritis and liver and kidney dysfunction [16,17] are also common in this population. Psychiatric disorders are often comorbid by ketamine include depression, which is remarkably prevalent among chronic ketamine users [18,19] [29]. However, it is still not clear if chronic ketamine intake is the cause or consequence of these brain alterations due to the cross-sectional design of these studies [28].Further, white matter microstructural abnormalities were found predominantly in left prefrontal region in ketamine chronic users when [27], restricted to the right hemisphere white matter regions when compared with poly-drug users [26]. While a significant correlation between the subgenual ACCdorsal medial prefrontal cortex connectivity and depression score was found in female ketamine users but not in female controls, it is hard to draw a conclusion whether it was ketamine use or depression that accounted for the discrepancy between ketamine users and controls [30].To date, there has been no established treatment for ketamine addiction. Abstinence seems to be the essential step for treating physical symptoms induced by ketamine [31] and probably depressive symptoms as well as cognitive impairments [20]. Lamotrigine, a glutamate release inhibitor showed promising effect in reducing ketamine craving ...

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Upper gastrointestinal problems in inhalational ketamine abusers

Abstract: Ketamine abusers frequently presented with upper GI symptoms, the commonest of which is epigastric pain (73% of abusers). Abstinence from ketamine abuse can lead to the relief of symptoms, which is an important message for ketamine abusers.

Cited by 69 publications

References 2 publications

Acute and Chronic Toxicity Pattern in Ketamine Abusers in Hong Kong

Acute and Chronic Toxicity Pattern in Ketamine Abusers in Hong Kong

Multiorgan Dysfunction Related to Chronic Ketamine Abuse

Ketamine Addiction

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