Medications

Ketamine isn't an opioid and treats depression in a unique way

Ketamine has gotten a bad rap as an opioid when there's plenty of evidence suggesting it isn't one, Johns Hopkins experts say. They believe this reputation may hamper patients from getting necessary treatment for the kinds ...

Medications

Expert urges cautious approach to ketamine use

Physicians and patients are excited about ketamine, the latest drug to treat depression, but Stanford psychiatrist Alan Schatzberg says we need to tread carefully.

Medications

Psychedelic drugs: Would you accept a prescription?

In countries such as the UK, US and Australia, strict laws and international conventions prohibiting the use of psychedelic drugs have made it almost impossible to research how these drugs work, and how they might be used ...

Medications

New drug mimics benefits of ketamine for depression

A new small-molecule drug produced a rapid antidepressant response similar to that of ketamine when tested in mice, a new Yale-led study published April 16 in the Journal of Clinical Investigation shows.

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Ketamine

Ketamine is a drug used in human and veterinary medicine. Its hydrochloride salt is sold as Ketanest, Ketaset, and Ketalar. Pharmacologically, ketamine is classified as an NMDA receptor antagonist. At high, fully anesthetic level doses, ketamine has also been found to bind to opioid μ receptors type 2 in cultured human neuroblastoma cells, however without agonist activity, and to sigma receptors in rats. Also, ketamine interacts with muscarinic receptors, descending monoaminergic pain pathways and voltage-gated calcium channels. Like other drugs of this class such as tiletamine and phencyclidine (PCP), it induces a state referred to as "dissociative anesthesia" and is used as a recreational drug.

Ketamine has a wide range of effects in humans, including analgesia, anesthesia, hallucinations, elevated blood pressure, and bronchodilation. Ketamine is primarily used for the induction and maintenance of general anesthesia, usually in combination with a sedative. Other uses include sedation in intensive care, analgesia (particularly in emergency medicine), and treatment of bronchospasm. It has been shown to be effective in treating depression in patients with bipolar disorder who have not responded to other anti-depressants. In persons with major depressive disorder it produces a rapid antidepressant effect, acting within two hours as opposed to the several weeks taken by typical antidepressants to work. It is also a popular anesthetic in veterinary medicine.

Ketamine is a chiral compound. Most pharmaceutical preparations of ketamine are racemic; however, some brands reportedly have (mostly undocumented) differences in enantiomeric proportions. The more active enantiomer, (S)-ketamine, is also available for medical use under the brand name Ketanest S. (R)-ketamine, (S)-ketamine & racemic (R,S)-ketamine all have qualitatively separate distinct effect profiles, although S has the most active potency. Ketamine is a core medicine in the World Health Organization's "Essential Drugs List", a list of minimum medical needs for a basic health care system.

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