Skip to main content

Advertisement

SpringerLink
Log in

Risks Associated with Misuse of Ketamine as a Rapid-Acting Antidepressant

  • Perspective
  • Published:
Neuroscience Bulletin Aims and scope Submit manuscript

Abstract

Major depression is a serious psychiatric disorder and remains a leading cause of disability worldwide. Conventional antidepressants take at least several weeks to achieve a therapeutic response and this lag period has hindered their ability to attain beneficial effects in depressed individuals at high risk of suicide. The non-competitive N-methyl-D-aspartate glutamate receptor antagonist ketamine has been shown to have rapid antidepressant effects in both rodents and humans. The emergence of ketamine as a fast-acting antidepressant provides promising new insights into the development of a rapid treatment response in patients with clinical depression. However, its safety and toxicity remain a concern. In this review, we focus on the limitations of ketamine, including neurotoxicity, cognitive dysfunction, adverse events associated with mental status, psychotomimetic effects, cardiovascular events, and uropathic effects. Studies have shown that its safety and tolerability profiles are generally good at low doses and with short-term treatment in depressed patients. The adverse events associated with ketamine usually occur with very high doses that are administered for prolonged periods of time and can be relieved by cessation. The antidepressant actions of its two enantiomers, S-ketamine (esketamine) and R-ketamine, are also discussed. R-ketamine has greater antidepressant actions than S-ketamine, without ketamine-related side-effects. Future treatment strategies should consider using R-ketamine for the treatment of depressed patients to decrease the risk of adverse events associated with long-term ketamine use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Jama 2003, 289: 3095–3105.

    Article  PubMed  Google Scholar 

  2. Yilmaz A, Schulz D, Aksoy A, Canbeyli R. Prolonged effect of an anesthetic dose of ketamine on behavioral despair. Pharmacol Biochem Behav 2002, 71: 341–344.

    Article  CAS  PubMed  Google Scholar 

  3. Salat K, Siwek A, Starowicz G, Librowski T, Nowak G, Drabik U, et al. Antidepressant-like effects of ketamine, norketamine and dehydronorketamine in forced swim test: Role of activity at NMDA receptor. Neuropharmacology 2015, 99: 301–307.

    Article  CAS  PubMed  Google Scholar 

  4. Maeng S, Zarate CA, Jr., Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry 2008, 63: 349–352.

    Article  CAS  PubMed  Google Scholar 

  5. Li N, Liu RJ, Dwyer JM, Banasr M, Lee B, Son H, et al. Glutamate N-methyl-D-aspartate receptor antagonists rapidly reverse behavioral and synaptic deficits caused by chronic stress exposure. Biol Psychiatry 2011, 69: 754–761.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Zarate CA, Jr., Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry 2006, 63: 856–864.

    Article  CAS  PubMed  Google Scholar 

  7. Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, et al. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry 2000, 47: 351–354.

    Article  CAS  PubMed  Google Scholar 

  8. Murrough JW, Iosifescu DV, Chang LC, Al Jurdi RK, Green CE, Perez AM, et al. Antidepressant efficacy of ketamine in treatment-resistant major depression: a two-site randomized controlled trial. Am J Psychiatry 2013, 170: 1134–1142.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Murrough JW, Perez AM, Pillemer S, Stern J, Parides MK, aan het Rot M, et al. Rapid and longer-term antidepressant effects of repeated ketamine infusions in treatment-resistant major depression. Biol Psychiatry 2013, 74: 250–256.

  10. Pompili M, Innamorati M, Gonda X, Serafini G, Sarno S, Erbuto D, et al. Affective temperaments and hopelessness as predictors of health and social functioning in mood disorder patients: a prospective follow-up study. J Affect Disord 2013, 150: 216–222.

    Article  PubMed  Google Scholar 

  11. Serafini G, Howland RH, Rovedi F, Girardi P, Amore M. The role of ketamine in treatment-resistant depression: a systematic review. Curr Neuropharmacol 2014, 12: 444–461.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Ionescu DF, Swee MB, Pavone KJ, Taylor N, Akeju O, Baer L, et al. Rapid and sustained reductions in current suicidal ideation following repeated doses of intravenous ketamine: secondary analysis of an open-label study. J Clin Psychiatry 2016, 77: e719–725.

    Article  PubMed  Google Scholar 

  13. Zhang MW, Harris KM, Ho RC. Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications. BMC Med Ethics 2016, 17: 4.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rudin M, Ben-Abraham R, Gazit V, Tendler Y, Tashlykov V, Katz Y. Single-dose ketamine administration induces apoptosis in neonatal mouse brain. J Basic Clin Physiol Pharmacol 2005, 16: 231–243.

    Article  CAS  PubMed  Google Scholar 

  15. Scallet AC, Schmued LC, Slikker W, Jr., Grunberg N, Faustino PJ, Davis H, et al. Developmental neurotoxicity of ketamine: morphometric confirmation, exposure parameters, and multiple fluorescent labeling of apoptotic neurons. Toxicol Sci 2004, 81: 364–370.

    Article  CAS  PubMed  Google Scholar 

  16. Zhao T, Li C, Wei W, Zhang H, Ma D, Song X, et al. Prenatal ketamine exposure causes abnormal development of prefrontal cortex in rat. Sci Rep 2016, 6: 26865.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Zhao T, Li Y, Wei W, Savage S, Zhou L, Ma D. Ketamine administered to pregnant rats in the second trimester causes long-lasting behavioral disorders in offspring. Neurobiol Dis 2014, 68: 145–155.

    Article  CAS  PubMed  Google Scholar 

  18. Clancy B, Kersh B, Hyde J, Darlington RB, Anand KJ, Finlay BL. Web-based method for translating neurodevelopment from laboratory species to humans. Neuroinformatics 2007, 5: 79–94.

    Article  PubMed  Google Scholar 

  19. Lodge D, Anis NA, Burton NR. Effects of optical isomers of ketamine on excitation of cat and rat spinal neurones by amino acids and acetylcholine. Neurosci Lett 1982, 29: 281–286.

    Article  CAS  PubMed  Google Scholar 

  20. Anis NA, Berry SC, Burton NR, Lodge D. The dissociative anaesthetics, ketamine and phencyclidine, selectively reduce excitation of central mammalian neurones by N-methyl-aspartate. Br J Pharmacol 1983, 79: 565–575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Smith DJ, Bouchal RL, deSanctis CA, Monroe PJ, Amedro JB, Perrotti JM, et al. Properties of the interaction between ketamine and opiate binding sites in vivo and in vitro. Neuropharmacology 1987, 26: 1253–1260.

    Article  CAS  PubMed  Google Scholar 

  22. Eide PK, Stubhaug A, Breivik H, Oye I. Reply to S.T. Meller: Ketamine: relief from chronic pain through actions at the NMDA receptor. Pain 1997, 72: 289–291.

    Article  CAS  PubMed  Google Scholar 

  23. Kapur S, Seeman P. NMDA receptor antagonists ketamine and PCP have direct effects on the dopamine D(2) and serotonin 5-HT(2)receptors-implications for models of schizophrenia. Mol Psychiatry 2002, 7: 837–844.

    Article  CAS  PubMed  Google Scholar 

  24. Jevtovic-Todorovic V, Wozniak DF, Benshoff ND, Olney JW. A comparative evaluation of the neurotoxic properties of ketamine and nitrous oxide. Brain Res 2001, 895: 264–267.

    Article  CAS  PubMed  Google Scholar 

  25. Jevtovic-Todorovic V, Carter LB. The anesthetics nitrous oxide and ketamine are more neurotoxic to old than to young rat brain. Neurobiol Aging 2005, 26: 947–956.

    Article  CAS  PubMed  Google Scholar 

  26. Ubogu EE, Sagar SM, Lerner AJ, Maddux BN, Suarez JI, Werz MA. Ketamine for refractory status epilepticus: a case of possible ketamine-induced neurotoxicity. Epilepsy Behav 2003, 4: 70–75.

    Article  PubMed  Google Scholar 

  27. Morgan CJ, Riccelli M, Maitland CH, Curran HV. Long-term effects of ketamine: evidence for a persisting impairment of source memory in recreational users. Drug Alcohol Depend 2004, 75: 301–308.

    Article  CAS  PubMed  Google Scholar 

  28. Liao Y, Tang J, Ma M, Wu Z, Yang M, Wang X, et al. Frontal white matter abnormalities following chronic ketamine use: a diffusion tensor imaging study. Brain 2010, 133: 2115–2122.

    Article  PubMed  Google Scholar 

  29. Behrens MM, Ali SS, Dugan LL. Interleukin-6 mediates the increase in NADPH-oxidase in the ketamine model of schizophrenia. J Neurosci 2008, 28: 13957–13966.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Zhang Y, Behrens MM, Lisman JE. Prolonged exposure to NMDAR antagonist suppresses inhibitory synaptic transmission in prefrontal cortex. J Neurophysiol 2008, 100: 959–965.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Schobel SA, Chaudhury NH, Khan UA, Paniagua B, Styner MA, Asllani I, et al. Imaging patients with psychosis and a mouse model establishes a spreading pattern of hippocampal dysfunction and implicates glutamate as a driver. Neuron 2013, 78: 81–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Diamond PR, Farmery AD, Atkinson S, Haldar J, Williams N, Cowen PJ, et al. Ketamine infusions for treatment resistant depression: a series of 28 patients treated weekly or twice weekly in an ECT clinic. J Psychopharmacol 2014, 28: 536–544.

    Article  PubMed  Google Scholar 

  33. Rasmussen KG, Lineberry TW, Galardy CW, Kung S, Lapid MI, Palmer BA, et al. Serial infusions of low-dose ketamine for major depression. J Psychopharmacol 2013, 27: 444–450.

    Article  CAS  PubMed  Google Scholar 

  34. Shiroma PR, Johns B, Kuskowski M, Wels J, Thuras P, Albott CS, et al. Augmentation of response and remission to serial intravenous subanesthetic ketamine in treatment resistant depression. J Affect Disord 2014, 155: 123–129.

    Article  CAS  PubMed  Google Scholar 

  35. Segmiller F, Ruther T, Linhardt A, Padberg F, Berger M, Pogarell O, et al. Repeated S-ketamine infusions in therapy resistant depression: a case series. J Clin Pharmacol 2013, 53: 996–998.

    Article  CAS  PubMed  Google Scholar 

  36. Morgan CJ, Mofeez A, Brandner B, Bromley L, Curran HV. Acute effects of ketamine on memory systems and psychotic symptoms in healthy volunteers. Neuropsychopharmacology 2004, 29: 208–218.

    Article  CAS  PubMed  Google Scholar 

  37. Honey GD, Honey RA, Sharar SR, Turner DC, Pomarol-Clotet E, Kumaran D, et al. Impairment of specific episodic memory processes by sub-psychotic doses of ketamine: the effects of levels of processing at encoding and of the subsequent retrieval task. Psychopharmacology (Berl) 2005, 181: 445–457.

    Article  CAS  Google Scholar 

  38. Morgan CJ, Curran HV. Acute and chronic effects of ketamine upon human memory: a review. Psychopharmacology (Berl) 2006, 188: 408–424.

    Article  CAS  Google Scholar 

  39. Honey GD, Honey RA, O’Loughlin C, Sharar SR, Kumaran D, Suckling J, et al. Ketamine disrupts frontal and hippocampal contribution to encoding and retrieval of episodic memory: an fMRI study. Cereb Cortex 2005, 15: 749–759.

    Article  CAS  PubMed  Google Scholar 

  40. Krystal JH, Karper LP, Seibyl JP, Freeman GK, Delaney R, Bremner JD, et al. Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses. Arch Gen Psychiatry 1994, 51: 199–214.

    Article  CAS  PubMed  Google Scholar 

  41. Malhotra AK, Pinals DA, Weingartner H, Sirocco K, Missar CD, Pickar D, et al. NMDA receptor function and human cognition: the effects of ketamine in healthy volunteers. Neuropsychopharmacology 1996, 14: 301–307.

    Article  CAS  PubMed  Google Scholar 

  42. Umbricht D, Schmid L, Koller R, Vollenweider FX, Hell D, Javitt DC. Ketamine-induced deficits in auditory and visual context-dependent processing in healthy volunteers: implications for models of cognitive deficits in schizophrenia. Arch Gen Psychiatry 2000, 57: 1139–1147.

    Article  CAS  PubMed  Google Scholar 

  43. Krystal JH, D’Souza DC, Karper LP, Bennett A, Abi-Dargham A, Abi-Saab D, et al. Interactive effects of subanesthetic ketamine and haloperidol in healthy humans. Psychopharmacology (Berl) 1999, 145: 193–204.

    Article  CAS  Google Scholar 

  44. Newcomer JW, Farber NB, Jevtovic-Todorovic V, Selke G, Melson AK, Hershey T, et al. Ketamine-induced NMDA receptor hypofunction as a model of memory impairment and psychosis. Neuropsychopharmacology 1999, 20: 106–118.

    Article  CAS  PubMed  Google Scholar 

  45. Krystal JH, Perry EB, Jr., Gueorguieva R, Belger A, Madonick SH, Abi-Dargham A, et al. Comparative and interactive human psychopharmacologic effects of ketamine and amphetamine: implications for glutamatergic and dopaminergic model psychoses and cognitive function. Arch Gen Psychiatry 2005, 62: 985–994.

    Article  CAS  PubMed  Google Scholar 

  46. Cho HS, D’Souza DC, Gueorguieva R, Perry EB, Madonick S, Karper LP, et al. Absence of behavioral sensitization in healthy human subjects following repeated exposure to ketamine. Psychopharmacology (Berl) 2005, 179: 136–143.

    Article  CAS  Google Scholar 

  47. Perry EB, Jr., Cramer JA, Cho HS, Petrakis IL, Karper LP, Genovese A, et al. Psychiatric safety of ketamine in psychopharmacology research. Psychopharmacology (Berl) 2007, 192: 253–260.

    Article  CAS  Google Scholar 

  48. McGirr A, Berlim MT, Bond DJ, Fleck MP, Yatham LN, Lam RW. A systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials of ketamine in the rapid treatment of major depressive episodes. Psychol Med 2015, 45: 693–704.

    Article  CAS  PubMed  Google Scholar 

  49. Hong LE, Summerfelt A, Buchanan RW, O’Donnell P, Thaker GK, Weiler MA, et al. Gamma and delta neural oscillations and association with clinical symptoms under subanesthetic ketamine. Neuropsychopharmacology 2010, 35: 632–640.

    Article  PubMed  Google Scholar 

  50. Pinault D. N-methyl d-aspartate receptor antagonists ketamine and MK-801 induce wake-related aberrant gamma oscillations in the rat neocortex. Biol Psychiatry 2008, 63: 730–735.

    Article  CAS  PubMed  Google Scholar 

  51. Wang X, Chen Y, Zhou X, Liu F, Zhang T, Zhang C. Effects of propofol and ketamine as combined anesthesia for electroconvulsive therapy in patients with depressive disorder. J Ect 2012, 28: 128–132.

    Article  PubMed  Google Scholar 

  52. Sos P, Klirova M, Novak T, Kohutova B, Horacek J, Palenicek T. Relationship of ketamine’s antidepressant and psychotomimetic effects in unipolar depression. Neuro Endocrinol Lett 2013, 34: 287–293.

    CAS  PubMed  Google Scholar 

  53. Kitagawa H, Yamazaki T, Akiyama T, Mori H, Sunagawa K. Effects of ketamine on in vivo cardiac sympathetic nerve endings. J Cardiovasc Pharmacol 2001, 38 Suppl 1: S39–42.

    Article  CAS  PubMed  Google Scholar 

  54. Sklar GS, Zukin SR, Reilly TA. Adverse reactions to ketamine anaesthesia. Abolition by a psychological technique. Anaesthesia 1981, 36: 183–187.

    Article  CAS  PubMed  Google Scholar 

  55. Shahani R, Streutker C, Dickson B, Stewart RJ. Ketamine-associated ulcerative cystitis: a new clinical entity. Urology 2007, 69: 810–812.

    Article  PubMed  Google Scholar 

  56. Tam YH, Ng CF, Pang KK, Yee CH, Chu WC, Leung VY, et al. One-stop clinic for ketamine-associated uropathy: report on service delivery model, patients’ characteristics and non-invasive investigations at baseline by a cross-sectional study in a prospective cohort of 318 teenagers and young adults. BJU Int 2014, 114: 754–760.

    Article  CAS  PubMed  Google Scholar 

  57. Chu PS, Ma WK, Wong SC, Chu RW, Cheng CH, Wong S, et al. The destruction of the lower urinary tract by ketamine abuse: a new syndrome? BJU Int 2008, 102: 1616–1622.

    Article  PubMed  Google Scholar 

  58. Lai Y, Wu S, Ni L, Chen Z, Li X, Yang S, et al. Ketamine-associated urinary tract dysfunction: an underrecognized clinical entity. Urol Int 2012, 89: 93–96.

    Article  CAS  PubMed  Google Scholar 

  59. Jalil R, Gupta S. Illicit ketamine and its bladder consequences: is it irreversible? BMJ Case Rep 2012, 2012.

  60. Tsai JH, Tsai KB, Jang MY. Ulcerative cystitis associated with ketamine. Am J Addict 2008, 17: 453.

    Article  PubMed  Google Scholar 

  61. Lapidus KA, Levitch CF, Perez AM, Brallier JW, Parides MK, Soleimani L, et al. A randomized controlled trial of intranasal ketamine in major depressive disorder. Biol Psychiatry 2014, 76: 970–976.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Opler LA, Opler MG, Arnsten AF. Ameliorating treatment-refractory depression with intranasal ketamine: potential NMDA receptor actions in the pain circuitry representing mental anguish. CNS Spectr 2016, 21: 12–22.

    Article  PubMed  Google Scholar 

  63. Hashimoto K. Letter to the Editor: R-ketamine: a rapid-onset and sustained antidepressant without risk of brain toxicity. Psychol Med 2016, 46: 2449–2451.

    Article  CAS  PubMed  Google Scholar 

  64. Domino EF. Taming the ketamine tiger. 1965. Anesthesiology 2010, 113: 678–684.

    PubMed  Google Scholar 

  65. Manji H, Mullard A. Husseini Manji. Nat Rev Drug Discov 2015, 14: 742–743.

  66. Singh JB, Fedgchin M, Daly E, Xi L, Melman C, De Bruecker G, et al. Intravenous esketamine in adult treatment-resistant depression: a double-blind, double-randomization, placebo-controlled study. Biol Psychiatry 2015, 80: 424–431.

    Article  PubMed  Google Scholar 

  67. Yang C, Shirayama Y, Zhang JC, Ren Q, Yao W, Ma M, et al. R-ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects. Transl Psychiatry 2015, 5: e632.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Zhang JC, Li SX, Hashimoto K. R (-)-ketamine shows greater potency and longer lasting antidepressant effects than S (+)-ketamine. Pharmacol Biochem Behav 2014, 116: 137–141.

    Article  CAS  PubMed  Google Scholar 

  69. Hashimoto K, Kakiuchi T, Ohba H, Nishiyama S, Tsukada H. Reduction of dopamine D2/3 receptor binding in the striatum after a single administration of esketamine, but not R-ketamine: a PET study in conscious monkeys. Eur Arch Psychiatry Clin Neurosci 2016. doi:10.1007/s00406-016-0692-7.

    Google Scholar 

  70. Javitt DC, Zukin SR. Recent advances in the phencyclidine model of schizophrenia. Am J Psychiatry 1991, 148: 1301–1308.

    Article  CAS  PubMed  Google Scholar 

  71. Singh JB, Fedgchin M, Daly EJ, De Boer P, Cooper K, Lim P, et al. A double-blind, randomized, placebo-controlled, dose-frequency study of intravenous ketamine in patients with treatment-resistant depression. Am J Psychiatry 2016, 173: 816–826.

    Article  Google Scholar 

  72. Yang C, Han M, Zhang JC, Ren Q, Hashimoto K. Loss of parvalbumin-immunoreactivity in mouse brain regions after repeated intermittent administration of esketamine, but not R-ketamine. Psychiatry Res 2016, 239: 281–283.

    Article  CAS  PubMed  Google Scholar 

  73. Vollenweider FX, Leenders KL, Oye I, Hell D, Angst J. Differential psychopathology and patterns of cerebral glucose utilisation produced by (S)- and (R)-ketamine in healthy volunteers using positron emission tomography (PET). Eur Neuropsychopharmacol 1997, 7: 25–38.

    Article  CAS  PubMed  Google Scholar 

  74. Ionescu DF, Luckenbaugh DA, Niciu MJ, Richards EM, Slonena EE, Vande Voort JL, et al. Effect of baseline anxious depression on initial and sustained antidepressant response to ketamine. J Clin Psychiatry 2014, 75: e932–938.

    Article  CAS  PubMed  Google Scholar 

  75. Diazgranados N, Ibrahim L, Brutsche NE, Newberg A, Kronstein P, Khalife S, et al. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry 2010, 67: 793–802.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Cusin C, Ionescu DF, Pavone KJ, Akeju O, Cassano P, Taylor N, et al. Ketamine augmentation for outpatients with treatment-resistant depression: Preliminary evidence for two-step intravenous dose escalation. Aust N Z J Psychiatry 2016. doi:10.1177/0004867416631828.

    PubMed  Google Scholar 

  77. Nguyen L, Marshalek PJ, Weaver CB, Cramer KJ, Pollard SE, Matsumoto RR. Off-label use of transmucosal ketamine as a rapid-acting antidepressant: a retrospective chart review. Neuropsychiatr Dis Treat 2015, 11: 2667–2673.

    PubMed  PubMed Central  Google Scholar 

  78. Zarate CA, Jr., Brutsche NE, Ibrahim L, Franco-Chaves J, Diazgranados N, Cravchik A, et al. Replication of ketamine’s antidepressant efficacy in bipolar depression: a randomized controlled add-on trial. Biol Psychiatry 2012, 71: 939–946.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This article was supported by the National Natural Science Foundation of China (81371489) and by the Strategic Research Program for Brain Sciences from the Japan Agency for Medical Research and Development, AMED.

Author information

Authors and Affiliations

  1. National Institute on Drug Dependence, Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191, China

    Weili Zhu, Zengbo Ding, Yinan Zhang, Jie Shi & Lin Lu

  2. Institute of Mental Health/Peking University Sixth Hospital, Key Laboratory of Mental Health, Beijing, 100191, China

    Lin Lu

  3. Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, 260-8670, Japan

    Kenji Hashimoto

Authors
  1. Weili Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zengbo Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yinan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jie Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kenji Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lin Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lin Lu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhu, W., Ding, Z., Zhang, Y. et al. Risks Associated with Misuse of Ketamine as a Rapid-Acting Antidepressant. Neurosci. Bull. 32, 557–564 (2016). https://doi.org/10.1007/s12264-016-0081-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12264-016-0081-2

Keywords

Search

Navigation