KETAMINES PSYCHOLOGICAL EFFECTS DO NOT CONTRAINDICATE ITS USE BASED ON A PATIENTS OCCUPATION

Since ketamine wets approved for clinical use, there has been debate o ver whether the psychological effects of ketamine warrant avoiding use of the drug in patients based on their occupation. This article revie ws the literature to determine if such concerns are valid. After 25 ye ars of clinical experience with ketamine, fewer than 10 cases document the occurrence of delayed psychological effects potentially attributa ble to that drug. In most cases, the delayed effects were temporary, r esolving within 3 weeks. Further, there were no long-term psychologica l effects clearly attributable to ketamine. Children who manifested de layed effects had several other factors present placing them at risk f or long-term psychological changes independent of their receiving keta mine. Several controlled studies investigating the risk of long-term p sychological effects due to ketamine fail to document that the risk of permanent psychological changes from ketamine is any greater than tha t from any other anesthetic. In conclusion, there is no evidence in th e literature that ketamine presents a higher risk compared to other an esthetics for causing long-term psychological effects that result in a patient not being able to return to his or her occupation. The decisi on of whether to use ketamine should be a clinical decision weighing r elative risks versus benefits, and not a decision based on the patient 's career.