Ketamine: 50 Years of Modulating the Mind

Summary & key facts

Ketamine has been used in medicine since the 1960s. Doctors and scientists still find it useful and interesting because it works on many parts of the brain and we do not fully understand how. Researchers have used ketamine to study how anesthesia works. Evidence suggests ketamine may cause anesthesia by disrupting information flow from the front to the back of the brain. It is widely used in anesthesiology and critical care because it keeps the heart and breathing more stable than some other drugs while sedating and reducing pain. There is also growing, early evidence that ketamine might help people whose depression or post-traumatic stress disorder has not improved with other treatments, but its brain effects are still being studied.

Key facts:

• Ketamine was first put into medical use in the 1960s and is still used today.
• Scientists say ketamine acts on many different molecular targets in the brain, and its full effects are not yet fully understood.
• Researchers have used ketamine to study how anesthetics work, because it has unusual brain effects that teach us about general anesthesia.
• One idea from the research is that ketamine may produce anesthesia by breaking down the brain's flow of information from the front (frontal) areas to the back (parietal) areas.
• That same front-to-back disruption pattern has also been seen with some other kinds of anesthetic drugs.
• Clinically, ketamine is valuable in anesthesia and intensive care because it provides sedation and pain relief while helping maintain stable heart and breathing function.
• There is emerging evidence that ketamine may help people with hard-to-treat depression and post-traumatic stress disorder, but this is still an active area of research.

Abstract

Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine's effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal ("top down") distribution. This proposed mechanism of general anesthesia has since been demonstrated with anesthetics in other pharmacological classes as well. Ketamine remains invaluable to the fields of anesthesiology and critical care medicine, in large part due to its ability to maintain cardiorespiratory stability while providing effective sedation and analgesia. Furthermore, there may be an emerging role for ketamine in treatment of refractory depression and Post-Traumatic Stress Disorder. In this article, we review the history of ketamine, its pharmacology, putative mechanisms of action and current clinical applications.

Topics

Neuroscience and Neuropharmacology Research Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Cognitive science Ketamine Neuroscience Psychology

Substances

Ketamine

Conditions & symptoms

Chronic Pain Depression PTSD Chronic pain Sadness or low mood