Ketamine

Ketamine is a <a href="/facts/Cyclohexanone/Hf3YTWjB">cyclohexanone</a>-derived <a href="/facts/General_anaesthetic/YNM2tqty">general anesthetic</a> and <a href="/facts/NMDA_receptor_antagonist/4VJvEpdK">NMDA receptor antagonist</a> with <a href="/facts/Analgesic/xLj4XBcq">analgesic</a> and <a href="/facts/Hallucinogen/gn35weCu">hallucinogenic</a> properties, used medically for <a href="/facts/Anesthesia/b3MKVn8E">anesthesia</a>, <a href="/facts/Depression_(mood)/GDNFWm1L">depression</a>, and <a href="/facts/Pain_management/El1f7CEz">pain management</a>. Ketamine exists as its <a href="/facts/Esketamine/4FM0G8FI">S- (esketamine)</a> and <a href="/facts/Arketamine/FMDlT5Ne">R- (arketamine)</a> two <a href="/facts/Enantiomer/wjPv5J3y">enantiomers</a> and has antidepressant action likely involving additional mechanisms than NMDA antagonism.
At anesthetic doses, ketamine induces a state of dissociative anesthesia, a <a href="/facts/Trance/bggQcUcm">trance</a>-like state providing pain relief, <a href="/facts/Sedation/wFWEChs8">sedation</a>, and <a href="/facts/Amnesia/PaMeGJH7">amnesia</a>. Its distinguishing features as an anesthestic are preserved breathing and airway reflexes, stimulated heart function with increased <a href="/facts/Blood_pressure/VtqqSM2J">blood pressure</a>, and moderate <a href="/facts/Bronchodilation/IQMu7bra">bronchodilation</a>. As an anesthetic, it is used especially in trauma, <a href="/facts/Emergency_medical_services/K1uGpEH0">emergency</a>, and <a href="/facts/Pediatrics/hnkMfLeg">pediatric</a> cases. At lower, sub-anesthetic doses, it is used as a treatment for <a href="/facts/Pain/70E79oUn">pain</a> and <a href="/facts/Treatment-resistant_depression/0JM2IcFa">treatment-resistant depression</a>. 
Ketamine is legally used in medicine but is also tightly controlled due to its potential for recreational use and <a href="/facts/Dissociative/5aaD39vM">dissociative</a> effects. Ketamine is used as a recreational drug for its <a href="/facts/Hallucinogen/gn35weCu">hallucinogenic</a> and dissociative effects. When used recreationally, it is found both in crystalline powder and liquid form, and is often referred to by users as "Ket", "Special K" or simply "K". The long-term effects of repeated use are largely unknown and are an area of active investigation. Liver and urinary toxicity have been reported among regular users of high doses of ketamine for recreational purposes. Ketamine can cause <a href="/facts/Dissociation_(psychology)/MX81IGk3">dissociation</a> and nausea, and other adverse effects, and is <a href="/facts/Contraindication/HawhU8x9">contraindicated</a> in severe <a href="/facts/Cardiovascular_disease/HD420nMv">heart</a> or <a href="/facts/Liver_disease/NHtuS0gU">liver disease</a>, uncontrolled <a href="/facts/Psychosis/cVGd7MKK">psychosis</a>, pregnancy, and infants under 3 months. Ketamine’s effects are enhanced by <a href="/facts/Propofol/t34FW3fL">propofol</a>, <a href="/facts/Midazolam/mpw0AEvr">midazolam</a>, and <a href="/facts/Naltrexone/SVduEm3W">naltrexone</a>; reduced by <a href="/facts/Lamotrigine/mRmmMuj2">lamotrigine</a>, <a href="/facts/Nimodipine/cs4282xV">nimodipine</a>, and <a href="/facts/Clonidine/xPebaeST">clonidine</a>; and <a href="/facts/Benzodiazepine/IgbJr4jy">benzodiazepines</a> may blunt its antidepressant action.
Ketamine was first synthesized in 1962; it is derived from <a href="/facts/Phencyclidine/4LaNo5Cl">phencyclidine</a> in pursuit of a safer anesthetic with fewer hallucinogenic effects. It was approved for use in the United States in 1970. It has been regularly used in <a href="/facts/Veterinary_medicine/KYNaodgl">veterinary medicine</a> and was extensively used for <a href="/facts/General_anaesthesia/bv3Yzcz7">surgical anesthesia</a> in the <a href="/facts/Vietnam_War/W0gfbGTE">Vietnam War</a>. It later gained prominence for its rapid antidepressant effects discovered in 2000, marking a major breakthrough in depression treatment. A 2023 meta-analysis concluded that racemic ketamine, especially at higher doses, is more effective and longer-lasting than esketamine in reducing depression severity. It is on the <a href="/facts/WHO_Model_List_of_Essential_Medicines/6kmu81Xm">World Health Organization's List of Essential Medicines</a>. It is available as a <a href="/facts/Generic_medication/IF6AXDVX">generic medication</a>.

Ketamine open-in-new

Ketamine