Safety and tolerance of oral ketamine: A systematic review.
Psychiatry and clinical neurosciences May 30, 2026 Nathalia Novaretti, Rebeca Mendes P Pessoa, Jaime Eduardo Cecílio Hallak et al.
Oral ketamine shows a favorable short-term safety profile across a range of uses, including depression, chronic pain, and pediatric sedation, based on a systematic review of 18 randomized controlled trials involving adults, children, and healthy volunteers. Adverse effects were predominantly mild and transient; in depression studies (427 participants), effects were mild, and pediatric premedication trials (239 participants) reported transient neurological effects without significant safety concerns. Pain and experimental studies (372 participants) showed mostly mild adverse events, with dissociative symptoms at higher doses. Dizziness, sedation, and dissociation were more common with ketamine, while serious adverse events were rare. However, the certainty of evidence is low, and long-term safety remains uncertain.