Adverse Effects Associated With High-Dose Ketamine Infusions For Refractory Pain And Psychiatric Conditions

Curr Pain Headache Rep. 2025 Jun 19;29(1):93. doi: 10.1007/s11916-025-01408-w.

ABSTRACT

PURPOSE OF REVIEW: As higher doses of ketamine are being used in numerous medical conditions such as Complex Regional Pain Syndrome (CRPS), it is critical to examine common adverse effects (AEs) explicitly associated with high doses of ketamine (HDK).

RECENT FINDINGS: HDK is often associated with psychiatric symptoms such as agitation, anxiety, and sleep disturbances. Psychiatric effects have been documented in various methods of administration of HDK, including oral, intravenous, and intranasal formulations. Emesis is a common AE of HDK and is more prevalent at higher ketamine doses. Hepatotoxicity is common after HDK, is dose-dependent, and is usually transient. HDK-induced uropathy is another potential AE. When monitored appropriately, HDK administered in a hospital setting appears safe; practitioners should be mindful that certain AEs of HDK are likely dose-dependent.

PMID:40536569 | DOI:10.1007/s11916-025-01408-w