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Neurobiological Mechanisms of Ketamine Use, its Addiction, and Withdrawal: A Mini Review.

Current reviews in clinical and experimental pharmacology
March 3, 2025
Sin Hui Ng et al. (8 authors)
Journal ArticleHuman Study
Study Details

Study Goal

The researchers aimed to explore the neurobiological mechanisms of ketamine's addictive potential, withdrawal effects, and its impact on brain networks and neurotransmitter systems, as well as its repurposing as a fast-acting antidepressant.

Results Summary

Ketamine alters brain networks and neurotransmitter systems (glutamate and dopamine), contributing to addiction and withdrawal. Low-dose ketamine affects cortisol secretion and HPA axis dysregulation, potentially explaining its antidepressant effects, but it also carries risks like heart instability, respiratory depression, and liver injury.

Population

Global population, with noted prevalence in East and Southeast Asia.

Effective Dosage

Low-dose mentioned (specific amount not provided).

Duration

Not specified.

Interactions

None mentioned.

Extracted Claims (11)
InterventionDirectionEndpointPopulationDosageImpactClaim #
ketamine
increase
addiction
-
-
can lead to
#1
ketamine
increase
severe withdrawal symptoms
-
-
can lead to the development of
#2
ketamine
increase
brain networks
-
-
alters
#3
ketamine
decrease
somesthetic sensation
-
-
affecting
#4
ketamine
increase
heart and blood vessel instability
-
-
may cause
#5
ketamine
increase
respiratory depression
-
-
may cause
#6
ketamine
increase
liver injury
-
-
may cause
#7
ketamine
increase
hallucinations
-
-
may cause
#8
ketamine
increase
reliance
-
-
might induce
#9
low-dose ketamine
increase
secretion of stress hormone cortisol
-
-
can alter
#10
low-dose ketamine
increase
hypothalamic-pituitary-adrenal (HPA) axis dysregulation
-
-
can cause
#11
Abstract

Ketamine, a substance used for anesthesia and known for inducing dissociation, can lead to addiction and the development of severe withdrawal symptoms. Ketamine alters brain networks before affecting somesthetic sensation. Ketamine abuse was especially prevalent in East and Southeast Asia, and its popularity has continued to expand globally in recent decades. Ketamine is gaining popularity in the public and private sectors as a cheaper off-label depression treatment. Unfortunately, ketamine may cause side effects, such as heart and blood vessel instability, respiratory depression, liver injury, hallucinations, etc. The pain-relieving and mental effects of ketamine might induce reliance; thus, it should be used cautiously. This review highlights the neurobiological processes underpinnings of ketamine's addictive potential, withdrawal, and its effects on brain networks like the prefrontal cortex, hippocampus, and mesolimbic pathway, which play vital roles in decision-making, memory, and reward processing. In addition, the involvement of neurotransmitter systems, specifically glutamate and dopamine, in mediating the addictive properties of ketamine and the neuroadaptive changes that occurred during withdrawal are also discussed. It also explains that low-dose ketamine can alter the secretion of stress hormone cortisol and hypothalamic-pituitary-adrenal (HPA) axis dysregulation, possibly attributed to the current repurposing study of ketamine as a fast-acting antidepressant. Understanding these pathways is essential for developing effective ketamine addiction treatments, managing withdrawal symptoms, and possibly reversing brain changes for the betterment of human health and psychological well- being.

Study Links
Quality Scores
Safety30
Efficacy65/10
Quality75/10
Research Impact Scores
APT Score0.05
Weight Score2.50
Normalized Score0.53
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