Ketamine Abuse


Ketamine abuse in the context of therapeutic ketamine patients is a concern because although ketamine has demonstrated efficacy in treating various psychiatric disorders, it also has the potential for abuse and addiction. In recent years, ketamine has been increasingly used as an off-label treatment for depression, anxiety, PTSD, and other mental health conditions due to its rapid and robust antidepressant effects (Sanacora et al., 2017). However, ketamine is also a dissociative anesthetic and a popular recreational drug, known as “Special K” or “K,” which is often misused for its hallucinogenic and dissociative properties (Morgan et al., 2004).

The risk of ketamine abuse among therapeutic patients can be attributed to several factors. Firstly, the therapeutic effects of ketamine require frequent administration, which may increase the risk of developing tolerance and addiction (Short et al., 2018). Secondly, some patients may be predisposed to substance abuse, making them vulnerable to misusing ketamine (Morgan et al., 2004). Lastly, the availability and ease of obtaining ketamine may contribute to its misuse.

It is essential to carefully monitor and manage ketamine use in therapeutic settings to minimize the risk of abuse. Clinicians should follow guidelines and best practices, including appropriate patient selection, dosing, and monitoring. In addition, more research is needed to understand better the long-term effects of therapeutic ketamine use, potential risks, and practical strategies to minimize abuse among patients receiving ketamine treatment.


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Morgan C. J. A., Curran H. V., & Independent Scientific Committee on Drugs (2012) Ketamine use: a review. Addiction, 107(1):27-38. doi:10.1111/j.1360-0443.2011.03576.x

Short B., Fong J., Galvez V., Shelker W., & Loo C. K. (2018) Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry, 5(1):65-78. doi:10.1016/S2215-0366(17)30272-9

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Krystal J. H., Abdallah C. G., Sanacora G., Charney D. S., & Duman R. S. (2019) Ketamine: A Paradigm Shift for Depression Research and Treatment. Neuron, 101(5):774-778. doi:10.1016/j.neuron.2019.02.005

Janssen Research & Development (2019) Janssen Announces U.S. FDA Approval of SPRAVATO™ (esketamine) CIII Nasal Spray for Adults with Treatment-Resistant Depression (TRD) Who Have Cycled Through Multiple Treatments Without Relief. [Press Release] Retrieved from https://www.janssen.com/us/sites/www_janssen_com_usa/files/spravato_escetamine_press_release_030519.pdf

Sisti D., Segal A. G., Thase M. E. (2020) Proceed with Caution: Off-Label Ketamine Treatment of Major Depressive Disorder. Current Psychiatry Reports, 22(12):79. doi:10.1007/s11920-020-01201-6

Wilkinson S. T., Ballard E. D., Bloch M. H., Mathew S. J., Murrough J. W., Feder A., Sos P., Wang G., Zarate Jr. C. A., Sanacora G. (2018) The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis. American Journal of Psychiatry, 175(2):150-158. doi:10.1176/appi.ajp.2017.17040472

Schatzberg A. F. (2019) A Word of Caution on Esketamine. American Journal of Psychiatry, 176(6):422-424. doi:10.1176/appi.ajp.2019.19030311


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