Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug

Aroni, Filippia; Iacovidou, Nicoletta; Dontas, Ismene; Pourzitaki, Chryssa; Xanthos, Theodoros

doi:10.1177/0091270009337941

Cited by 161 publications

(119 citation statements)

References 53 publications

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“…Other potential medical uses of ketamine are currently under investigation. In particular, ketamine is being tested for the treatment of antidepressant-resistant mood disorders and for heroin and alcohol addiction (Krupitsky and Grinenko, 1997;Krystal, 2007;Aroni et al, 2009;Li et al, 2010;Vollenweider and Kometer, 2010).…”

Section: Introductionmentioning

confidence: 99%

The role of setting for ketamine abuse: clinical and preclinical evidence

Luca¹,

Meringolo²,

Spagnolo³

et al. 2012

Reviews in the Neurosciences

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(2012) The role of setting for ketamine abuse: clinical and preclinical evidence. Reviews in the neurosciences, 23 (5-6). pp. 769-780. ISSN 0334-1763 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/57391/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. The role of setting for ketamine abuse: clinical and preclinical evidence Abstract: Drug abuse is often seen as a unitary phenomenon, partly as a result of the discovery over the past three decades of shared mechanisms of action for addictive substances. Yet the pattern of drug taking is often very different from drug to drug. This is particularly evident in the case of ' club drugs ' , such as ketamine. Although the number of ketamine abusers is relatively small in the general population, it is quite substantial in some settings. In particular, ketamine abuse is almost exclusively limited to clubs and large music parties, which suggests a major role of context in modulating the reward effects of this drug. This review focuses on recent preclinical and clinical findings, including previously unpublished data, that provide evidence that, even under controlled conditions, ketamine reward is a function of the setting of drug taking.

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Section: Introductionmentioning

confidence: 99%

The role of setting for ketamine abuse: clinical and preclinical evidence

Luca¹,

Meringolo²,

Spagnolo³

et al. 2012

Reviews in the Neurosciences

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“…Although it was originally noted for its anesthetic effects, ketamine has numerous pharmacological properties, including the capacity to block amine uptake in the descending inhibitory monoaminergic pain pathways, interactions with muscarinic receptors, local anesthetic action and the ability to act as a kappa opioid agonist (34). Previous studies have reported that ketamine administered via continuous intravenous infusion enhances the analgesic effect of morphine even after the effect of ketamine had ceased in obstetric patients, while also being safe for both mother and baby and not affecting breastfeeding (35,36).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of prophylactic epidural ketamine for reducing shivering in patients undergoing caesarean section with combined spinal‑epidural anesthesia

Xue

Zhao

et al. 2018

biom rep

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Abstract.Intravenous ketamine is known to inhibit postoperative shivering; however, at present, there has been little research on whether this effect may be achieved with epidural application. The aim of the present study was to evaluate the efficacy and safety of epidural ketamine as a prophylactic agent to prevent shivering in patients undergoing caesarean section during combined spinal-epidural anesthesia. A prospective, randomized, double-blind study was performed. A total of 60 patients who were undergoing elective caesarean section under combined spinal-epidural anesthesia and had an American Society of Anesthesiologists physical status of I or II were recruited. Patients were randomly allocated to group S (epidural administration of normal saline; n=30) or group K (epidural ketamine 0.5 mg/kg; n=30). An investigator, blinded to the treatment groups, graded postoperative shivering using a 4-point scale and postoperative sedation on a 5-point scale. Operative time, hemodynamic changes and side effects, including hypotension, bradycardia, nausea and hallucinations, were recorded. The results demonstrated that patients' characteristics were not significantly different between groups. Heart rate, peripheral capillary oxygen saturation (SpO 2 ) values and Apgar scores at 1 and 5 min also did not differ significantly between groups. The incidence and severity of shivering in group K was significantly reduced compared with group S (P<0.05). The mean arterial pressure (MAP) was significantly different in groups S and K compared with baseline values at 10, 30 and 60 min (P<0.05). Furthermore, MAP values at 10, 30 and 60 min were significantly higher in group K compared with in group S (P<0.05). The results of the present study suggest that epidural administration of prophylactic low-dose ketamine may be an effective strategy for preventing postoperative shivering.

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“…Ketamine is an N-methyl-D-aspartate (NMDA) receptor agonist and phencyclidine derivative first approved for clinical use in 1970 [36,37]. Administered in doses of 1-2 mg/kg intravenously (IV) or 3-5 mg/kg intramuscularly (IM), it produces a dissociative state which leaves intact the airway-protective reflexes of coughing, sneezing, and swallowing [36,37].…”

Section: Ketaminementioning

confidence: 99%

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

Tennyson

2015

Curr Emerg Hosp Med Rep

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Asthma is an episodic disease of the airways characterized by inflammation and constriction of the bronchi. It has a significant societal impact with over 25 million persons affected in the United States alone and annually accounts for approximately 3300 deaths in the US. Standard therapy for acute severe asthma is effective for most patients, but controversies exist surrounding the care of the impending or actual respiratory failure patient. Non-invasive positive pressure ventilation has been effective in multiple case reports, but lacks large trial evidence to support its use. Intravenous ketamine similarly has supporting case reports, but an absence of rigorous evidence. Finally, parenteral beta-adrenergic medications have a long history of use, but have not been consistently shown to be superior to inhaled short-acting beta agonists. Further, they have been associated with higher rates of adverse effects.

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Pharmacological Aspects and Potential New Clinical Applications of Ketamine: Reevaluation of an Old Drug

Cited by 161 publications

References 53 publications

The role of setting for ketamine abuse: clinical and preclinical evidence

The role of setting for ketamine abuse: clinical and preclinical evidence

Efficacy of prophylactic epidural ketamine for reducing shivering in patients undergoing caesarean section with combined spinal‑epidural anesthesia

Controversies in the Care of the Acute Asthmatic in the Prehospital and Emergency Department Environments

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