ketamine / Generic mfg. - LARVOL DELTA

Secondary Sclerosing Cholangitis Following Febrile Infection-Related Epilepsy Syndrome in a Teenager (ACG 2026) - "He required ICU care exceeding four months, mechanical ventilation, ketamine and thiopentone for burst suppression, vasopressors, immunotherapy with methylprednisolone, intravenous immunoglobulin, rituximab, and plasmapheresis, and ketogenic diet. Young survivors of refractory neurological emergencies are an underrecognized at-risk population for SSC-CIP. Figure: Severe cachexia in a 19-year-old following prolonged ICU care for FIRES, complicated by secondary sclerosing cholangitis."

Cachexia • Cholestasis • CNS Disorders • Epilepsy • Fibrosis • Hepatology • Immunology • Infectious Disease • Inflammation • Pneumonia • Primary Biliary Cholangitis • Respiratory Diseases • Septic Shock • Tuberculosis

High on Ketamine and Gastric Pressure: A Case of Ketamine-Induced Gastric Pneumatosis (ACG 2026) - "This case highlights the differentiation of benign gastric emphysema versus emphysematous gastritis. Figure: Figure 1: Radiologic Differentiation of Benign Gastric Emphysema from Emphysematous Gastritis on Computed Tomography"

Clinical • Cholestasis • Constipation • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Inflammation • Liver Failure • Mucositis • Pulmonary Disease • Respiratory Diseases • Urology

Ketamine-Induced Sclerosing Cholangiopathy Mimicking Autoimmune Hepatobiliary Disease (ACG 2026) - "Additionally, KISC is thought to cause direct biliary epithelial toxicity from ketamine metabolites and NMDA receptor-mediated bile stasis. Early recognition and ketamine cessation are critical, as progressive biliary stricturing and irreversible hepatobiliary injury may occur with continued use."

Acute Kidney Injury • Autoimmune Hepatitis • Gastrointestinal Disorder • Hepatology • Immunology • Inflammation • Liver Failure • Nephrology • Primary Biliary Cholangitis • Primary Sclerosing Cholangitis • Renal Disease

Ketamine-Induced Cholangiopathy in a Young Patient Presenting With Nausea and Right Upper Quadrant Pain (ACG 2026) - "Thorough assessment and early recognition of therapeutic or recreational substance use may help lead to earlier diagnosis and prevent progression to chronic biliary injury. Figure: Combined images of MRI, EUS, and ERCP showing biliary dilation and CBD stent in place."

Clinical • Biliary Cancer • CNS Disorders • Gastrointestinal Disorder • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Liver Failure • Mental Retardation • Pain

Fatal Ketamine-Associated Vanishing Bile Duct Syndrome in a Young Woman With Chronic Ketamine Use (ACG 2026) - "Clinicians should maintain a high index of suspicion for VBDS in patients presenting with unexplained cholestasis and a history of chronic ketamine use. Figure: Figure 1: Lymphocytic infiltrates with paucity of intrahepatic bile ducts demonstrated in more than 50% of the portal tracts (H&E, x40); View 1 Figure: Figure 2: Lymphocytic infiltrates with paucity of intrahepatic bile ducts (H&E, x40); View 2"

Clinical • Acute Kidney Injury • Anorexia • Cholestasis • Chronic Kidney Disease • Fibrosis • Gastroenterology • Hepatology • Immunology • Infectious Disease • Liver Failure • Nephrology • Renal Disease

Ketamine-Assisted Psychotherapy as a Novel Treatment for Refractory Irritable Bowel Syndrome: A Case Series (ACG 2026) - "He had previously failed treatment with as-needed loperamide, psyllium fiber, amitriptyline, alprazolam, and cognitive behavioral therapy...She had previously attempted a low-FODMAP and gluten-free diet, and had failed trials of an antispasmodic, psyllium fiber, and desipramine...By modulating central sensitization and the gut-brain axis, KAP may address both the visceral hypersensitivity and psychological comorbidities inherent to IBS. This case series represents the first report highlighting KAP as a potential therapy for refractory IBS, while more trials are currently underway."

Clinical • Cardiovascular • CNS Disorders • Depression • Diabetes • Gastrointestinal Disorder • Hypertension • Immunology • Metabolic Disorders • Mood Disorders • Post-traumatic Stress Disorder • Type 2 Diabetes Mellitus

Intraoperative Ketamine Versus Lidocaine Infusion on Postoperative Cognitive Dysfunction in Patients Undergoing Hip Surgery (clinicaltrials.gov) - P=N/A | N=120 | Completed | Sponsor: Tanta University

New trial • Cognitive Disorders

Samm50 Downregulation-Driven Mitochondrial Dysfunction Triggers Ferroptosis and Contributes to Ketamine-Induced Neurotoxicity and Cognitive Impairment. (PubMed, Neuropharmacology) - "In vitro, ferroptosis inhibitors Fer-1 and deferoxamine (DFO) reversed ketamine-induced cell death, Fe2+ overload, LPO, and MMP loss, but Fer-1 failed to restore ATP or Samm50 expression. MitoQ rescued ATP, MMP, and ROS...Collectively, ketamine induces hippocampal neurotoxicity and cognitive impairment via a two-step mechanism: it first downregulates Samm50, leading to primary mitochondrial dysfunction (energy failure and oxidative stress); this mitochondrial impairment then triggers ferroptosis through iron accumulation and suppression of GPX4/SLC7A11. Samm50 downregulation serves as a critical upstream event linking mitochondrial dysfunction to ferroptosis, representing a novel therapeutic target for ketamine-induced neuropsychiatric toxicity."

Journal • Alzheimer's Disease • Cognitive Disorders • Metabolic Disorders • Psychiatry • GPX4 • SLC7A11 • TFRC

Ketamine-Assisted Psychotherapy for Treatment-Resistant Depression (clinicaltrials.gov) - P2 | N=25 | Not yet recruiting | Sponsor: University of Rochester | Initiation date: Jun 2026 ➔ Dec 2026

Trial initiation date • CNS Disorders • Depression • Mood Disorders • Pain • Psychiatry

Sex-dependent effects of clozapine on PV interneurons, PNNs, and behavior in a neurodevelopmental model with schizophrenia-relevant phenotypes. (PubMed, Biomed Pharmacother) - "Here, we investigated sex-dependent effects of CLZ on parvalbumin (PV) interneurons, perineuronal nets (PNNs), ECM-related gene expression, and behavior in adult mice exposed to perinatal ketamine. Together, these findings reveal coordinated sex-dependent changes in PV interneuron- and ECM-related phenotypes, together with distinct behavioral responses following CLZ treatment. These observations support the hypothesis that ECM-related alterations may contribute to sex-dependent variability in CLZ response and reinforce the importance of incorporating sex as a biological variable in preclinical AP research."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Psychiatry • Schizophrenia • ACAN

Intracellular Crosstalk Between NMDA and Sigma-1 Receptors: A Novel Mechanistic Insight Relevant to Neuropsychiatric Pharmacotherapy. (PubMed, Cells) - "Experimental data demonstrate that pharmacological agents initially characterized as NMDAR antagonists-such as ketamine, dextromethorphan, and memantine-also interact with σ1R, suggesting that their therapeutic efficacy may arise from coordinated modulation of both receptor systems. These findings collectively indicate that the σ1R is a key regulatory element enabling proper NMDAR function and that disruption of this interaction may contribute to excitatory imbalance implicated in the pathophysiology of neuropsychiatric disorders. Recognizing the σ1R-NMDAR crosstalk as an integrated signaling axis may thus inform the development of dual-target therapeutic strategies aimed at improving neuronal resilience and clinical outcomes in psychiatric and neurodegenerative diseases."

Journal • Review • Addiction (Opioid and Alcohol) • B Cell Lymphoma • CNS Disorders • Lymphoma • Mental Retardation • Oncology • Psychiatry • BCL2

Ketamine Versus Dexmedetomidine as Adjuvants to Bupivacaine in Ultrasound Guided Bilateral Superficial Cervical Plexus Block in Thyroidectomy (clinicaltrials.gov) - P=N/A | N=60 | Completed | Sponsor: Tanta University

New trial

RETRACTED: Zanza et al. Ketamine in Acute Brain Injury: Current Opinion Following Cerebral Circulation and Electrical Activity. Healthcare 2022, 10, 566. (PubMed, Healthcare (Basel)) - "The journal retracts the article titled "Ketamine in acute brain injury: current opinion following cerebral circulation and electrical activity" [...]."

Journal • CNS Disorders • Vascular Neurology

BioSelect: Biomarker-Guided Antidepressant Selection (clinicaltrials.gov) - P4 | N=27 | Recruiting | Sponsor: Weill Medical College of Cornell University | Not yet recruiting ➔ Recruiting

Biomarker • Enrollment open • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Comparison of arterial blood pressure and quality of induction and recovery in horses anesthetized with diazepam or guaifenesin co-induction combined with xylazine and ketamine and maintained on isoflurane. (PubMed, Can J Vet Res) - "Requirements for dobutamine and/or phenylephrine for arterial blood pressure support were recorded. Induction scores were good to excellent [both groups: 0.5 (0, 2); median (range)]. In conclusion, guaifenesin and diazepam at the doses used in this study produced similar effects on arterial blood pressure and on the quality of induction and recovery."

Journal • Anesthesia

Perioperative Ketamine and Esketamine for Postoperative Mood Symptoms After Orthopaedic Surgery: A Systematic Review of Randomized Controlled Trials. (PubMed, Arch Bone Jt Surg) - "Further standardized trials are needed before firm conclusions can be drawn. II."

Journal • Review • CNS Disorders • Depression • Orthopedics • Psychiatry

Thalamofrontal synaptic weakening underlies short-term memory deficits from adolescent NMDAR hypofunction. (PubMed, Sci Adv) - "In mice repeatedly exposed to ketamine, STM impairment coincided with reduced release probability and attenuated short-term depression at mediodorsal thalamus (MD) → dorsomedial prefrontal cortex (dmPFC) synapses, without detectable changes in corticocortical synaptic release probability, intrinsic excitability, or gross synaptic ultrastructure...Chemogenetically strengthening MD → dmPFC projections restored both neural selectivity and behavior. These findings identify a projection-specific presynaptic mechanism through which adolescent NMDAR hypofunction weakens TF communication and produces cognitive impairment, offering a biological explanation for clinically observed TF dysconnectivity and establishing TF synapses as a therapeutic target."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Depression • Psychiatry • Schizophrenia

Real-World Therapeutic Use of Ketamine in Clinical and Non-Clinical Settings: A Cross-Sectional Survey. (PubMed, J Psychoactive Drugs) - "Non-clinical consumers presented higher odds of reporting long-term hallucinations following ketamine use (OR = 2.58, 95% CI: 1.08-6.31). The results of this study indicate a high self-reported effectiveness of ketamine in clinical and non-clinical settings while emphasizing the potential risks of side effects when used without medical supervision."

Journal • Real-world evidence • CNS Disorders • Depression • Mood Disorders • Psychiatry

Intraoperative Ketamine and Chronic Opioid Use After Lumbar Spine Surgery in Patients With and Without Opioid-Use Disorder: A Retrospective Database Analysis. (PubMed, Anesth Analg) - "In this large, real-world cohort, intraoperative ketamine was not associated with lower rates of chronic opioid dispensing after LSS in either opioid-naive or patients with OUD. These database findings reflect the absence of a detectable population-level opioid-sparing signal, and do not exclude dose- or protocol-dependent effects."

Journal • Retrospective data • Addiction (Opioid and Alcohol) • Orthopedics • Pain • Substance Abuse

Feasibility and tolerability of virtual reality during esketamine treatment: A pilot study. (PubMed, J Affect Disord) - "This pilot study examines factors affecting the feasibility and tolerability of VR during ketamine treatment and highlights considerations for future research. The observed reduction in 5D-ASC scores raises questions about whether VR dampens dissociative intensity, with potential clinical implications warranting further exploration."

Journal • CNS Disorders • Depression • Psychiatry

Reply to 'Methodological concerns and interpretative limitations of assessing subjective effects of ketamine'. (PubMed, Npj Ment Health Res) - "We discuss the potential influence of psychotherapy and differences in subjective-effect questionnaires across studies, acknowledging these as important limitations. We argue that these factors may partly explain observed treatment differences and highlight the need for future studies using standardized, multidimensional measures of subjective experience."

Journal

Matters arising: Methodological concerns and interpretative limitations of assessing subjective effects of ketamine. (PubMed, Npj Ment Health Res) - "The letter addresses critical issues in the methodology and conclusions of the meta-analysis, including inconsistencies in study design, methodological flaws in comparing correlation coefficients, and discrepancies in reported results and their interpretation. It contributes significantly to the ongoing discussion on psychedelic-assisted therapies and highlights the need for more standardized methodologies in future research."

Journal

Management of Cancer-Induced Bone Pain in Hospice and Palliative Care. (PubMed, J Hosp Palliat Care) - "Management should be grounded in systematic assessment and the WHO analgesic ladder, while recognizing that many hospice patients require early initiation of strong opioids, opioid rotation, rescue dosing, and selected adjuvant analgesics such as corticosteroids, gabapentinoids, and ketamine. Bone-modifying agents, including zoledronic acid and denosumab, can reduce skeletal-related events. A patient-centered, interdisciplinary approach, informed by the concept of "total pain," remains the cornerstone of effective bone pain management at the end of life."

Journal • Breast Cancer • CNS Disorders • Endocrine Disorders • Genito-urinary Cancer • Hematological Malignancies • Metabolic Disorders • Multiple Myeloma • Musculoskeletal Diseases • Musculoskeletal Pain • Oncology • Osteosarcoma • Pain • Palliative care • Prostate Cancer • Solid Tumor

Hesperidin attenuates cisplatin-induced cardiotoxicity in rats through regulating autophagy. (PubMed, Avicenna J Phytomed) - "A mixture of ketamine and xylazine was used to anesthetize all animals on day 8 to obtain blood and tissue samples and to record ECG. However, hesperidin (100, and 200 mg/kg) reversed these changes. Hesperidin could protect cardiac tissue against cisplatin administration by exerting its antioxidant effect and regulating autophagy in a dose-dependent manner."

Journal • Preclinical • Anesthesia • Cardiovascular • Oncology • BECN1

Ketamine versus Etomidate as an induction agent for tracheal intubation: An updated meta-analysis of randomized clinical trials. (PubMed, Anaesth Crit Care Pain Med) - "Neither ketamine nor etomidate conferred a survival advantage in critically ill patients. However, ketamine was associated with a higher risk of post-induction cardiovascular collapse based on a pooled analysis of two open-label trials, whereas etomidate was associated with a higher risk of adrenal insufficiency. The certainty of the evidence for cardiovascular collapse is limited by the small number of studies, the open-label design, and heterogeneity in the outcome definitions."

Clinical • Intubation • Journal • Retrospective data • Review • Cardiovascular • Endocrine Disorders • Nephrology • Renal Disease