Introduced fifty years ago as and labeled as the first dissociative anesthetic, ketamine produces both hypnosis and analgesia, unique among anesthetic drugs. The use of ketamine for surgical anesthesia, however, has been limited because of its unwanted psychotropic effects. Over the past couple of decades, interest in the administration of sub-anesthetic doses of ketamine, that mostly avoid side effects, for relief of acute and chronic pain has grown steadily. The increasing use of ketamine has rekindled research examining its myriad pharmacologic properties that relate to pain mechanisms beginning with its well-known antagonism of the NMDA receptor, but more recently extends to its action at opioid, muscarinic, AMPA, monoaminergic, kainite and GABA receptors as well as sodium, potassium and L-type calcium channels. Coupled with new interest in opioid-sparing strategies in the treatment of acute and chronic pain, ketamine research and use is accelerating and forging interest in drugs with similar mechanistic and psychomimetic profiles.
For this Research Topic we will collect original research articles, reviews and perspectives to elucidate further the mechanistic pharmacology of ketamine as it relates to pain therapeutics as well as best practices, based on rigorous clinical pharmacology. The sub-themes of this Research Topic include but are not limited to the following:
1. NMDA receptor modulation of central sensitization and wind-up.
2. Ketamine efficacy for peripheral neuropathic pain.
3. Ketamine treatment of mood disorders and the link between pain perception and affective mood disorders, focusing on non-NMDAR effects (e.g., GABA and AMPA receptors).
4. Ketamine as part of an opioid-sparing strategy for acute surgical pain (e.g. current evidence and best practices).
5. Ketamine formulations, routes of administration and pharmacokinetic-pharmacodynamic relationships as they relate to treatment of acute and, especially, chronic pain therapeutics.
6. Related hallucinogenic and psychotropic drugs for the treatment of pain (e.g., psilocybin and LSD).
Articles derived from both animal and human research are welcome.
Introduced fifty years ago as and labeled as the first dissociative anesthetic, ketamine produces both hypnosis and analgesia, unique among anesthetic drugs. The use of ketamine for surgical anesthesia, however, has been limited because of its unwanted psychotropic effects. Over the past couple of decades, interest in the administration of sub-anesthetic doses of ketamine, that mostly avoid side effects, for relief of acute and chronic pain has grown steadily. The increasing use of ketamine has rekindled research examining its myriad pharmacologic properties that relate to pain mechanisms beginning with its well-known antagonism of the NMDA receptor, but more recently extends to its action at opioid, muscarinic, AMPA, monoaminergic, kainite and GABA receptors as well as sodium, potassium and L-type calcium channels. Coupled with new interest in opioid-sparing strategies in the treatment of acute and chronic pain, ketamine research and use is accelerating and forging interest in drugs with similar mechanistic and psychomimetic profiles.
For this Research Topic we will collect original research articles, reviews and perspectives to elucidate further the mechanistic pharmacology of ketamine as it relates to pain therapeutics as well as best practices, based on rigorous clinical pharmacology. The sub-themes of this Research Topic include but are not limited to the following:
1. NMDA receptor modulation of central sensitization and wind-up.
2. Ketamine efficacy for peripheral neuropathic pain.
3. Ketamine treatment of mood disorders and the link between pain perception and affective mood disorders, focusing on non-NMDAR effects (e.g., GABA and AMPA receptors).
4. Ketamine as part of an opioid-sparing strategy for acute surgical pain (e.g. current evidence and best practices).
5. Ketamine formulations, routes of administration and pharmacokinetic-pharmacodynamic relationships as they relate to treatment of acute and, especially, chronic pain therapeutics.
6. Related hallucinogenic and psychotropic drugs for the treatment of pain (e.g., psilocybin and LSD).
Articles derived from both animal and human research are welcome.