Molecular Mechanisms and Toxic Effects of Ketamine.
Fa yi xue za zhi April 25, 2025 Yu-Meng Zuo, Wei Han, Jian-Bo Zhang et al.
Ketamine, a dissociative anesthetic used clinically for surgical anesthesia, can cause nerve damage, adverse emotional reactions, and other toxic side effects when abused. Its primary mechanism blocks N-methyl-D-aspartate receptors (NMDAR), but it also acts through multiple other pathways including AMPAR, opioid receptors, GABA receptors, monoaminergic receptors, cholinergic receptors, HCN channels, voltage-gated sodium channels, and L-type voltage-dependent calcium channels. This review summarizes the molecular mechanisms and toxic effects of ketamine to support forensic applications such as identifying symptomatic phenotypes of ketamine toxicity and detecting ketamine abuse.