The hitchhiker's guide to ketamine-induced cystitis
OA Version
Citation
Abstract
Ketamine, widely used as an anesthetic since the 1970s, recently gained U.S. Food and Drug Administration (FDA) approval for treatment-resistant depression as a nasal spray. The use of off-label IV ketamine for pain relief, depression, and suicidal ideation has yielded promising results, but the consequences of long-term ketamine treatment have not received adequate attention. The dramatic, irreversible changes to the bladder seen in ketamine abusers and animal models should raise red flags, but the urgent need for effective depression medications prompted expedited FDA approval. Therefore, it is of the upmost importance to understand the deleterious effect of ketamine on the bladder and potentially other organ systems before a severely vulnerable patient population is exposed to dosages of ketamine that have yet to be examined for their long-term safety. Through an evaluation of current research, a two-pronged mechanism of ketamine-induced cystitis, involving nerve hypertrophy and incomplete apoptosis, was elucidated and may serve as a valuable guide for clinical care decisions, further research, and development of efficacious treatments