title: Ketamine use: a review.
abstract: OBJECTIVE
  Ketamine remains an important medicine in both specialist anaesthesia and aspects of pain management. At the same time, its use as a recreational drug has spread in many parts of the world during the past few years. There are now increasing concerns about the harmful physical and psychological consequences of repeated misuse of this drug. The aim of this review was to survey and integrate the research literature on physical, psychological and social harms of both acute and chronic ketamine use.
  
  
  METHODS
  The literature on ketamine was systematically searched and findings were classified into the matrix of Nutt et al.'s (2007) rational scale for assessing the harms of psychoactive substances.
  
  
  RESULTS
  A major physical harm is ketamine induced ulcerative cystitis which, although its aetiology is unclear, seems particularly associated with chronic, frequent use of the drug. Frequent, daily use is also associated with neurocognitive impairment and, most robustly, deficits in working and episodic memory. Recent studies suggest certain neurological abnormalities which may underpin these cognitive effects. Many frequent users are concerned about addiction and report trying but failing to stop using ketamine.
  
  
  CONCLUSIONS
  The implications of these findings are drawn out for treatment of ketamine-induced ulcerative cystitis in which interventions from urologists and from addiction specialists should be coordinated. Neurocognitive impairment in frequent users can impact negatively upon achievement in education and at work, and also compound addiction problems. Prevention and harm minimization campaigns are needed to alert young people to these harmful and potentially chronic effects of ketamine.
authors.affiliation: Clinical Psychopharmacology Unit, Clinical Health Psychology, University College London, London, UK.
authors.forename: Celia J A
authors.initials: CJ
authors.lastname: Morgan
authors.forename: H Valerie
authors.initials: HV
authors.lastname: Curran
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000208:Acute Disease; D000778:Anesthetics, Dissociative / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000818:Animals; D016739:Behavior, Addictive / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000139:chemically induced; D003556:Cystitis / Q000139:chemically induced*; D004522:Educational Status; D006801:Humans; D007649:Ketamine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced*; D051381:Rats; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine