Multiorgan dysfunction related to chronic ketamine abuse PMC

ketamine abuse effects

Rehabilitation centers can help with different treatment options, detox programs, and other necessary assistance for overcoming dependency. Cognitive behavioral therapy can assist with changing the thought patterns that play a role in supporting drug use and addiction. This leaves plenty of room for excessive amounts of ketamine to be taken, amounts which can lead to an overdose. provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated 3 Mar 2024), Cerner Multum™ (updated 4 Mar 2024), ASHP (updated 10 Mar 2024) and others. Withdrawal symptoms may include chills, sweats, excitation, hallucinations, teary eyes, and drug cravings.

The researchers assessed the effects of repeated exposure to the drug at two doses, one dose analogous to the dose used to model depression treatment in mice, and another closer to the dose that induces anesthesia. The included studies followed a cross-sectional and retrospective design with considerable variability among studies in terms of subject age, ketamine type and dosage. It should be noted that in some studies, ketamine users had a mood disorder and for many of the studies it was unclear whether the ketamine users were diagnosed with another substance use disorder or another psychiatric illness. Part of the structural and functional neuroanatomical differences could therefore be attributed to these concomitant conditions. Finally, we were unable to receive a few records containing potentially relevant data. Third, since subjects were mostly recreational users, they might have used ketamine shortly before data were obtained.

  1. The patient was further managed with oral and intravenous hydration, a multivitamin supplement, and omeprazole.
  2. An abdominal ultrasonographic study revealed complete resolution of the hepatobiliary abnormalities, the hydronephrosis, and the hydroureter on both sides.
  3. Esophagogastroduodenoscopy showed grade 3 esophagitis and mild gastritis.
  4. Full recovery from the hepatobiliary disease over time has been observed with complete abstinence from ketamine abuse (10, 11).

Within 3 hours, at least half of the active ingredients in ketamine consumed will have left the body. Ketamine can be dangerous, particularly when combined with other substances. It is largely non-fatal when used alone—there is little on record of a lethal dose of this drug in humans. However, this drug can be fatal because it is usually combined with other substances like alcohol (which also has sedative effects) or hallucinogens like LSD and PCP.


Getting support from friends, family, and professional facilities can assist you in overcoming your addiction and living your life free of substances. No medications have been FDA-approved to treat ketamine addiction, but doctors may prescribe other medications to help treat co-occurring mental health conditions. Hospitalization may sometimes be required mixing alcohol and hallucinogens to manage serious withdrawal symptoms. Treatment for ketamine addiction often involves some type of psychotherapy, such as cognitive-behavioral therapy (CBT), motivational enhancement therapy, family therapy, or group therapy. Ketamine addiction also makes it difficult for people to function as they normally do in their daily life and activities.

ketamine abuse effects

It also allows more synapses, which allow information to flow inside your brain, to form in the same area. “The restructuring of the brain’s dopamine system that we see after repeated ketamine use may be linked to cognitive behavioral changes over time,” Malika Datta, a co-author of the paper, said. While ketamine overdoses are not strongly linked to death, consuming large amounts of this drug can be fatal. With a diagnosis of ketamine-induced multisystem illness, he was advised to refrain from further drug abuse and was discharged to a community-based drug rehabilitation program. His general health steadily improved, and on a subsequent outpatient clinic visit 2 months later, he weighed 50 kg (a total weight gain of 8 kg). An abdominal ultrasonographic study revealed complete resolution of the hepatobiliary abnormalities, the hydronephrosis, and the hydroureter on both sides.

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In the same sample, the authors compared smoking chronic ketamine users with non-ketamine smokers and with non-ketamine, non-smokers by performing fMRI. They found a higher activation in the anterior cingulate cortex (ACC) in response to ketamine cues. Also, ketamine subjects showed lower activation in the cerebellum and the middle temporal cortex in response to natural rewarding (sexual) cues (Liao et al., 2018). We included 16 studies in our review, totaling 440 chronic ketamine users with a mean ketamine use of 2–9.7 years and 2.4 grams per day, compared to 259 drug-free controls and 44 poly-drug controls. Five studies were based on the same sample (Liao et al., 2010, 2011, 2012, 2016, 2018).

ketamine abuse effects

The findings bolster the case for developing ketamine therapies that target specific areas of the brain, rather than administering doses that wash the entire brain in ketamine. Urinary tract abnormalities are the most commonly reported chronic toxic effect related to ketamine abuse. With chronic use, the drug injures the urinary bladder, causing ulcers, cystitis, and fibrosis leading to urinary incontinence, hematuria, bladder overactivity and shrinkage, and, in the later stages, hydroureter and hydronephrosis (2, 6). The term “ketamine bladder syndrome” has been coined to describe this clinical entity. The smooth muscle relaxing property of ketamine was thought to be a pathogenic mechanism of urinary tract disease.

The most frequently reported side effects of short term ketamine (hours/days) are related to the nervous system, such as dissociation, sedation, headache, dizziness, blurred vision and memory impairment (Short et al., 2017). Small case series of ketamine administration in various doses for up to one year in patients with MDD or chronic pain suggest that some of these neural side effects may remain with prolonged ketamine use (Cvrcek, 2008; Szymkowicz et al., 2013). Within the ketamine users group, adolescent onset users were compared to adult onset users.

More on Substance Abuse and Addiction

If substance misuse disrupts work, school, and personal relationships, it can indicate a ketamine addiction. Tolerance can build to the effects over time, alcohol dependence withdrawal and relapse pmc requiring greater doses of the drug to reach the same level of effect. Reports suggest that the dissociative effect may also disappear over time.

More broadly, the study demonstrates that the same type of neurons located in different brain regions can be affected differently by the same drug,” Tomer said. “The study is charting a new technological frontier in how to conduct high-resolution studies of the entire brain,” said Yannan Chen, a co-author of the paper. It is the first successful attempt to map changes induced by chronic ketamine exposure at what is known as “sub-cellular resolution,” in other words, down to the level of seeing ketamine’s effects on parts of individual cells. The researchers’ highly detailed data also enabled them to track how ketamine affects dopamine networks across the brain.

Although recovery is observed in most cases with an early intervention, irreversible damage may occur in chronic cases. It must be noted that the reported changes were dependent on the dosage and duration of ketamine use which were substantially higher than for clinical use, so our findings cannot be translated to clinical ketamine use. Original studies about recreative ketamine use in which neuroanatomical measurements were performed, either structural or functional, were included. To obtain the articles meeting this inclusion criterion we first excluded all articles that were not about ketamine. Subsequently we excluded articles that were only about brain function and not about neuro-anatomical outcomes (e.g., performance on cognitive tests). Lastly, we excluded papers that were about animals or were no original investigations.

Ketamine itself or its active metabolites were believed to cause injury to the urinary tract, although adulterants in the abused drug preparation were proposed as the cause by some authorities. Direct damage, microvascular injury, and immune mechanisms were thought to be the etiological factors (7). Recent evidence suggests that cytotoxic damage to the urinary alcohol use disorder diagnosis and treatment tract by the drug is the cause for the abnormalities (8). By alteration of the epithelial cell-to-cell adhesion and cell coupling in the renal tract, ketamine causes damage through a nonclassical profibrotic mechanism. Ketamine abuse more than three times weekly for more than 2 years has been found to be a significant risk factor for urinary tract disease (9).

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