Sex, drugs, and arousal-two randomized trials on the effects of ketamine on sexual arousal and calcarine gyrus activity.
Therapeutic advances in psychopharmacology January 1, 2026 Manfred Klöbl, Thomas Liebe, Gregor Dörl et al.
Ketamine reduces sexual arousal in a sex-specific manner, which may explain why it is used recreationally in chemsex settings despite dampening sexual experience. In two placebo-controlled crossover studies with 67 healthy volunteers, subacute S-ketamine lowered arousal to heterosexual stimuli in women and to lesbian stimuli in men, while decreasing sexual aversion to gay stimuli in both sexes. Late racemic ketamine reduced arousal to heterosexual stimuli in men but increased aversion to gay stimuli in women. Ketamine also modulated calcarine gyrus activity differently in men and women. These sex-dependent effects on brain activity and sexual response may relate to ketamine's known sex-specific influences on stress resilience and psychosis-like symptoms.