Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings)
CNS Neuroscience & Therapeutics April 10, 2013 G. Mion, Thierry Villevieille 690 citations
For over 50 years, ketamine has been a safe anesthetic with potent pain-relieving properties. Its active form is S(+)-ketamine, and it is mainly metabolized into norketamine, an active metabolite. During dissociative anesthesia, sensory inputs reach the brain but are not perceived in some association areas. Ketamine also enhances the descending serotonin pathway for pain relief and has antidepressant effects. Pain relief persists at plasma concentrations ten times lower than those needed for hypnosis. By blocking the NMDA receptor, ketamine reduces the wind-up phenomenon and hyperalgesia, including opioid-induced hyperalgesia.