Ketamine, originally approved as a general anesthetic, is being explored for repurposing to treat depressive disorders, suicidal ideation, substance-use disorders, anxiety disorders, chronic pain, refractory status epilepticus, and bronchial asthma exacerbations. The nasal spray of esketamine, a more potent form, has been approved by the USFDA for treatment-resistant depression alongside oral antidepressants. However, concerns about long-term safety persist due to its psychedelic effects and potential for abuse. This review discusses ketamine's repurposing for therapeutic use and the associated safety concerns.
Ketamine dependence can develop in anesthesiologists, who have easy access to the drug. A case from India describes an anesthesiologist who experienced dissociation, depersonalization, and psychotic effects from ketamine, along with significant tolerance and cyclical use of very high doses, but without prominent physical withdrawal symptoms. The case highlights concerns about substance misuse among medical professionals and raises issues for patient safety and management of affected health workers.