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Ketamine

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Drug Abuse and Addiction in Medical Illness

Abstract

Ketamine (2-(2-chlorophenyl)-2-(methylamino)-cyclohexanone), an anaesthetic derivative of phencyclidine (PCP) with analgesic, neuroprotective and psychedelic properties, is an unusual anaesthetic in its ability to produce a “dissociative” state. It is the action (antagonism) at NMDA (N-methyl aspartate) receptors that is thought to underlie ketamine’s qualities. Whilst ketamine use in medicinal and veterinary settings is well documented and has a good safety record, the increase in its unregulated use outside of such controlled environments is a cause for concern. In non-medicinal use, the stereo-selective kinetics and the complex mechanism of action may lead to unpredictable effects. It is reported that the perceptual and mood changes observed in those who have consumed ketamine are highly sensitive to age, dose, route, previous experience and setting. At low doses stimulant effects predominate and environmental conditions are significant, but with higher doses psychedelic effects become the primary experience. When used recreationally in sub-therapeutic doses by inhalation (or insufflation) the alteration in perception of auditory, visual and painful stimuli result in a general “lack of responsive awareness” which puts the recreational user at risk of personal damage which can go unrecognized. The recreational use of this drug, the effects and potential risks associated with its unregulated use will be discussed.

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  1. Addiction Science, Institute of Psychiatry, King’s College London, Addiction Sciences Building, 4 Windsor Walk, London, SE5 8AF, UK

    Kim Wolff Ph.D.

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  1. Kim Wolff Ph.D.
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Editors and Affiliations

  1. Inst. Pharmaceutical Sciences, Department of Psychopharmacology, Utrecht University, Universiteitsweg 99, Utrecht, 3584CG, Netherlands

    Joris C. Verster

  2. Dept. Psychiatry, Medical University of South Carolina, President St. 67, Charleston, 29425, South Carolina, USA

    Kathleen Brady

  3. School of Medicine, Div. Alcoholism & Drug Abuse, New York University, First Ave. 550, New York, 10016, New York, USA

    Marc Galanter

  4. Institute of Psychiatry, King's College London, National Addiction Centre, Windsor Walk 4, London, SE5 8AF, United Kingdom

    Patricia Conrod

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Wolff, K. (2012). Ketamine. In: Verster, J., Brady, K., Galanter, M., Conrod, P. (eds) Drug Abuse and Addiction in Medical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3375-0_15

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  • DOI: https://doi.org/10.1007/978-1-4614-3375-0_15

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