Ketamine renaissance: Expanding horizons from anesthesia to depression and pain
Raja Suhail Shounthoo, Ajaiz Rasool, Athar Un Nisa Quraishi, Humaira Bashir, Falak Ara, Ishrat Yousuf
Asian Journal of Medical Sciences June 30, 2026 Peer reviewed DOI: 10.71152/ajms.v17i7.5333 via OpenAlex
Summary
Ketamine, a dissociative anesthetic developed in the 1960s, is experiencing a resurgence as a treatment for depression and pain. Unlike standard antidepressants that target monoamine systems, ketamine works by modulating glutamate, a key neurotransmitter, and enhancing synaptic plasticity. It shows rapid antidepressant effects in treatment-resistant depression and effectiveness for both acute and chronic pain. However, significant concerns remain about long-term safety, lack of standardized protocols, and potential for misuse. This review examines ketamine's expanding roles in anesthesia, psychiatry, and pain medicine, highlighting its mechanisms, clinical uses, safety issues, and gaps in current evidence.
Study at a glance
| Design | review |
|---|---|
| Key finding | Ketamine offers rapid antidepressant effects in treatment-resistant depression and efficacy in acute and chronic pain, but long-term safety, protocol standardization, and misuse potential remain unresolved. |
Abstract
Ketamine, a dissociative anesthetic introduced in the 1960s, has re-emerged as a versatile therapeutic agent extending beyond its traditional perioperative role. Its rapid antidepressant action in treatment-resistant depression and efficacy in acute and chronic pain syndromes have driven what is termed the “ketamine renaissance.” Unlike conventional monoaminergic antidepressants, ketamine primarily modulates glutamatergic neurotransmission, enhancing synaptic plasticity and influencing neuroinflammatory pathways. This review critically evaluates ketamine’s evolving role across anaesthesia, psychiatry, and pain medicine, highlighting mechanistic insights, clinical applications, safety concerns, and current evidence gaps. While ketamine offers significant therapeutic promise, issues related to long-term safety, standardization of protocols, and misuse potential remain unresolved.