Abstract | INTRODUCTION: AREAS COVERED: This review discusses the efficacy of subanesthetic doses of ketamine in alleviating chronic neuropathic pain, and highlights its pharmacokinetics and dynamics. The reader will understand under which treatment conditions ketamine is most effective, and through which mechanisms ketamine acts to induce long-term pain relief. The reader will gain an understanding of ketamine's complex metabolism and the role of its metabolite norketamine. Possible future alternatives for ketamine are discussed aimed at blockade of the subunit of the NMDAR involved in spinal and supraspinal pain pathways (NR2B). EXPERT OPINION: More proof from good-quality randomized clinical trials on the efficacy of NMDAR inhibitors is required. A major advantage of ketamine therapy is the ability of the molecule to induce rapid and potent antidepressant effects. This is relevant taken the fact that chronic pain and depression are closely linked and are often present in the same patient.
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Authors | Marieke Niesters, Albert Dahan |
Journal | Expert opinion on drug metabolism & toxicology
(Expert Opin Drug Metab Toxicol)
Vol. 8
Issue 11
Pg. 1409-17
(Nov 2012)
ISSN: 1744-7607 [Electronic] England |
PMID | 22871026
(Publication Type: Journal Article, Review)
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Chemical References |
- Receptors, N-Methyl-D-Aspartate
- Ketamine
- norketamine
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Topics |
- Animals
- Chronic Disease
- Disease Models, Animal
- Humans
- Ketamine
(analogs & derivatives, pharmacokinetics, therapeutic use)
- Neuralgia
(drug therapy)
- Randomized Controlled Trials as Topic
- Receptors, N-Methyl-D-Aspartate
(antagonists & inhibitors, metabolism)
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