Tharcila Chaves, PharmD PhD
Universtiy of Groningen
How dangerous is ketamine? A systematic review about deaths and overdoses related to the use of ketamine and its analogues
Ketamine is quickly opening its spot as a therapeutic option in the management of treatment-resistant depression, yet its abuse continues to be a worldwide issue. Because the duration of the antidepressant effect of ketamine is limited, re-dosing it after some weeks is necessary. If applying ketamine infusions either once or more often, clinicians need to consider the addictive potential and the risk of inducing psychosis-like symptoms. The use of ketamine analogues is also a point of concern. Intoxications involving new psychoactive substances and poly-substance use are common. The aim of this systematic review was to outline the cases of overdoses and deaths related to the use of ketamine and/or its analogues reported in the scientific literature. The following databases were searched: PubMed, EMBASE and CINAHL. Data collection was performed in July 2019. With a sample of 34 articles, eighteen describe fatal cases and sixteen describe overdoses. Importantly, some cases of over-sedation (i.e. cases that were not connected to drug abuse) were included as overdose cases. The over-sedation cases described in this study ratify the fact that dying from an exclusive ketamine overdose is not easy neither common. Although prescribers must remain vigilant, this should not deter appropriate prescribing, just like heroin abuse should not deter the adequate use of morphine. Finally, prevention and harm minimisation campaigns are needed to alert people about the potential damages caused by the acute and chronic use of ketamine and its analogues.
Tharcila Chaves is a pharmacist with a PhD in psychopharmacology. She recently defended her PhD thesis entitled "Through ketamine fields: pain and afterglow", at the University of Groningen (North Netherlands), in which she advocates for the use of ketamine to treat different types of pain and mental disorders, such as fibromyalgia, depression and post-traumatic stress disorder. With her origins in Brazil, she conducted her master's degree research at the Federal University of Sao Paulo (UNIFESP), using a qualitative approach to investigate cravings in crack cocaine users. Tharcila has worked as a care giver with harm reduction teams in festivals in South America and Europe. She has been part of the psychedelic scene (through art, culture, music, self-discovery and science) since the 90's. With the conclusion of her doctor's degree, she is turning to the entrepreneurial field, planning to contribute to the consolidation of psychedelic-assisted therapies as effective, safe and accessible treatment options.