Substance Abuse and Rehabilitation Dovepress to Use or Not to Use: an Update on Licit and Illicit Ketamine Use Adhi Wibowo Nurhidayat
Substance Abuse and Rehabilitation Dovepress to Use or Not to Use: an Update on Licit and Illicit Ketamine Use Adhi Wibowo Nurhidayat
复制标题
DOI：
--
复制
发表时间：
--
期刊：
影响因子：
--
通讯作者：
Jih-Heng Li;B. Vicknasingam;Y. Cheung;Wang-yuan Zhou;R. Schottenfeld
中科院分区：
文献类型：
--
作者：
Jih-Heng Li;B. Vicknasingam;Y. Cheung;Wang-yuan Zhou;R. Schottenfeld
氯胺酮是20世纪60年代开发的苯环利定的衍生物，是一种具有致幻作用的麻醉剂和镇痛剂。本文就氯胺酮的药理和毒理作用作一简要综述。氯胺酮具有广泛的安全边际，但这种治疗益处在某种程度上被其出现现象(心身分离和精神错乱)和致幻作用所抵消。氯胺酮的滥用越来越多，最初主要是在娱乐场所体验K洞和其他幻觉效果，但最近也作为一种药物在工作日或在家中滥用，进一步推动政府限制其在许多国家的使用。最近，尿路功能障碍与长期使用氯胺酮有关。在一些长期使用氯胺酮的人中，这种损害可能是不可逆转的，可能会导致肾功能衰竭和透析。虽然氯胺酮尚未列入联合国公约，但以往使用不同评估参数对毒品的总体危害进行评分的研究表明，氯胺酮造成的危害可能比一些联合国列入名单的药物更大。东南亚和东亚的一些国家报告说，氯胺酮滥用情况不断升级。在这些国家，与氯胺酮相关的症状中，依赖、下尿路功能障碍、性冲动或暴力是最显著的。这些结果表明，氯胺酮的危险性以前可能被低估了。因此，与氯胺酮相关的问题的严重程度应该得到更仔细和客观的审查。为了防止氯胺酮被不当使用并演变为流行病，必须对非法使用氯胺酮的流行率和特征进行彻底调查，以便采取适当的政策和措施。另一方面，最近的研究发现，氯胺酮可能有助于治疗严重的抑郁症，这给这种古老的药物带来了新的动力。如果氯胺酮真的是一种治疗抑郁症的药物，那么对其临床使用的风险和好处进行更多的研究将是必不可少的。
Ketamine, a derivative of phencyclidine that was developed in the 1960s, is an anesthetic and analgesic with hallucinogenic effects. In this paper, the pharmacological and toxicological effects of ketamine are briefly reviewed. Ketamine possesses a wide safety margin but such a therapeutic benefit is somewhat offset by its emergence phenomenon (mind-body dissociation and delirium) and hallucinogenic effects. The increasing abuse of ketamine, initially predominantly in recreational scenes to experience a " k-hole " and other hallucinatory effects but more recently also as a drug abused during the workday or at home, has further pushed governments to confine its usage in many countries. Recently, urinary tract dysfunction has been associated with long-term ketamine use. In some long-term ketamine users, such damage can be irreversible and could result in renal failure and dialysis. Although ketamine has not yet been scheduled in the United Nations Conventions, previous studies using different assessment parameters to score the overall harms of drugs indicated that ketamine may cause more harm than some of the United Nations scheduled drugs. Some countries in Southeast and East Asia have reported an escalating situation of ketamine abuse. Dependence, lower urinary tract dys-function, and sexual impulse or violence were the most notable among the ketamine-associated symptoms in these countries. These results implied that the danger of ketamine may have been underestimated previously. Therefore, the severity levels of the ketamine-associated problems should be scrutinized more carefully and objectively. To prevent ketamine from being improperly used and evolving into an epidemic, a thorough survey on the prevalence and characteristics of illicit ketamine use is imperative so that suitable policy and measures can be taken. On the other hand, recent findings that ketamine could be useful for treating major depressive disorder has given this old drug a new impetus. If ketamine is indeed a remedy for treating depression, more research on the risks and benefits of its clinical use will be indispensable.