Structural Neurotoxic and Neuroprotective Effects of Ketamine and Esketamine in Preclinical and Human Studies: A Systematic Review
Research Square May 27, 2026 Tychique T. Wasolua, Tanner J. Bommersbach, Roger S. McIntyre et al.
Ketamine and its S-enantiomer esketamine show both neurotoxic and neuroprotective effects depending on dose, duration, and experimental model. In preclinical studies, high or repeated doses can cause neuronal damage, while lower doses may protect against injury. Human studies are limited but suggest similar potential for harm and benefit. The systematic review highlights the need for careful dosing and monitoring in clinical use, especially for depression treatment.