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Drug Evaluations

Ketamine for the treatment of chronic non-cancer pain

, MD, , MD MSc, , MD PhD, , PhD, , MD PhD & , MD PhD
Pages 2417-2429 | Published online: 09 Sep 2010

Keep up to date with the latest research on this topic with citation updates for this article.

Read on this site (13)

Sandra J Drozdz, Akash Goel, Matthew W McGarr, Joel Katz, Paul Ritvo, Gabriella F Mattina, Venkat Bhat, Calvin Diep & Karim S Ladha. (2022) Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. Journal of Pain Research 15, pages 1691-1706.
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Brian N. Corwell, Sergey M. Motov, Natalie L. Davis & Hong K. Kim. (2022) Novel uses of ketamine in the emergency department. Expert Opinion on Drug Safety 21:8, pages 1009-1025.
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Tony Chung Tung Lo, Stephen Tung Yeung, Sujin Lee, Kira Skavinski & Solomon Liao. (2016) Reduction of central neuropathic pain with ketamine infusion in a patient with Ehlers–Danlos syndrome: a case report. Journal of Pain Research 9, pages 683-687.
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Jana Sawynok & Celia Zinger. (2016) Topical amitriptyline and ketamine for post-herpetic neuralgia and other forms of neuropathic pain. Expert Opinion on Pharmacotherapy 17:4, pages 601-609.
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Ece Esin & Suayib Yalcin. (2014) Neuropathic cancer pain: What we are dealing with? How to manage it?. OncoTargets and Therapy 7, pages 599-618.
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Joseph Pergolizzi, Karsten Ahlbeck, Dominic Aldington, Eli Alon, Flaminia Coluzzi, Albert Dahan, Frank Huygen, Magdalena Kocot-Kępska, Ana Cristina Mangas, Philippe Mavrocordatos, Bart Morlion, Gerhard Müller-Schwefe, Andrew Nicolaou, Concepción Pérez Hernández, Patrick Sichère, Michael Schäfer & Giustino Varrassi. (2013) The development of chronic pain: physiological CHANGE necessitates a multidisciplinary approach to treatment. Current Medical Research and Opinion 29:9, pages 1127-1135.
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Marieke Niesters, Maarten Swartjes, Lara Heij, Michael Brines, Anthony Cerami, Ann Dunne, Elske Hoitsma & Albert Dahan. (2013) The erythropoietin analog ARA 290 for treatment of sarcoidosis-induced chronic neuropathic pain. Expert Opinion on Orphan Drugs 1:1, pages 77-87.
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Marieke Niesters & Albert Dahan. (2012) Pharmacokinetic and pharmacodynamic considerations for NMDA receptor antagonists in the treatment of chronic neuropathic pain. Expert Opinion on Drug Metabolism & Toxicology 8:11, pages 1409-1417.
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Christian Martini, Erik Olofsen, Ashraf Yassen, Leon Aarts & Albert Dahan. (2011) Pharmacokinetic–pharmacodynamic modeling in acute and chronic pain: an overview of the recent literature. Expert Review of Clinical Pharmacology 4:6, pages 719-728.
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Mellar P Davis. (2011) Opioid tolerance and hyperalgesia: basic mechanisms and management in review. Progress in Palliative Care 19:2, pages 73-86.
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Sarbjeet S. Kalsi, David M. Wood & Paul I. Dargan. (2011) The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use. Emerging Health Threats Journal 4:1.
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Articles from other publishers (78)

John H. Krystal, Alfred P. Kaye, Sarah Jefferson, Matthew J. Girgenti, Samuel T. Wilkinson, Gerard Sanacora & Irina Esterlis. (2023) Ketamine and the neurobiology of depression: Toward next-generation rapid-acting antidepressant treatments. Proceedings of the National Academy of Sciences 120:49.
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Ruchir Gupta & Supurna Bhar. (2023) Maintenance IV Ketamine Therapy in the Fibromyalgia Patient: A Case Report. Health Psychology Research 11.
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Sina Marzoughi, David Ripsman & May Ong. (2023) Therapeutic effects of 7- to 14-day subanesthetic ketamine infusions for chronic pain on standardized psychiatric measures. Pain Management 13:9, pages 529-538.
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Theresa R. Lii & Vinita Singh. (2023) Ketamine for Complex Regional Pain Syndrome. Anesthesiology Clinics 41:2, pages 357-369.
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Daniella Batievsky, Michelle Weiner, Shari B. Kaplan, Michael Edward Thase, Domenick Nicholas Maglione & Denise Christina Vidot. (2023) Ketamine-assisted psychotherapy treatment of chronic pain and comorbid depression: a pilot study of two approaches. Frontiers in Pain Research 4.
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Alessandro Riccardi, Mario Guarino, Sossio Serra, Michele Spampinato, Simone Vanni, Dana Shiffer, Antonio Voza, Andrea Fabbri & Fabio De Iaco. (2023) Narrative Review: Low-Dose Ketamine for Pain Management. Journal of Clinical Medicine 12:9, pages 3256.
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Jacob Beiriger, Adnan Khan, Brian Yan, Heather Ross, Makala Wang, Michael Carducci, Natalia Salinas Parra, Salil Chowdhury, Ryan Erwin, Paul Forrest, Sarah Chen & Alexis Gerber. (2023) Comprehensive Review of Acute Pancreatitis Pain Syndrome. Gastrointestinal Disorders 5:2, pages 144-166.
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Thomas J. P. Mangnus, Maaike Dirckx, Krishna D. Bharwani, Sara J. Baart, Theodora A. M. Siepman, Ken Redekop, Willem A. Dik, Cecile C. de Vos & Frank J. P. M. Huygen. (2023) Intermittent versus continuous esketamine infusions for long-term pain modulation in complex regional pain syndrome: protocol of a randomized controlled non-inferiority study (KetCRPS-2). BMC Musculoskeletal Disorders 24:1.
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Nieves Saiz-Sapena & Manuel Granell-Gil. 2022. Ketamine Revisited - New Insights into NMDA Inhibitors. Ketamine Revisited - New Insights into NMDA Inhibitors.
Bhargab Deka, Biswajit Dash, Alakesh Bharali & Ashique Ahmed. 2022. Ketamine Revisited - New Insights into NMDA Inhibitors. Ketamine Revisited - New Insights into NMDA Inhibitors.
Doralina L Anghelescu, Stephanie Ryan, Diana Wu, Kyle J. Morgan, Tushar Patni & Yimei Li. (2022) Low‐dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients. Pediatric Blood & Cancer 69:9.
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G. Mion. (2022) Ketamina. EMC - Anestesia-Rianimazione 27:2, pages 1-17.
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G. Mion. (2022) Ketamina. EMC - Anestesia-Reanimación 48:2, pages 1-18.
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Amokrane Chebini, Sina Marzoughi, Jason Randhawa, Daphne Guh, Stephen Wiseman, Ingrid Fedoroff & May Ong. (2022) The effects of a multiday (10–14 days) subanesthetic dose IV ketamine infusion in the treatment of refractory chronic pain. Pain Management 12:3, pages 337-346.
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Thomas J.P. Mangnus, Krishna D. Bharwani, Dirk L. Stronks, Maaike Dirckx & Frank J.P.M. Huygen. (2022) Ketamine therapy for chronic pain in The Netherlands: a nationwide survey. Scandinavian Journal of Pain 22:1, pages 97-105.
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M. Alves, I. Cruz da Fonseca & D. Durães. (2021) P.0443 Esketamine, on the path of pain management. European Neuropsychopharmacology 53, pages S323-S324.
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Samantha Cotter, Jennie Wong, Neha Gada, Rajdeep Gill, S. Christopher Jones, Grace Chai, Daniel Foster, Mark Avigan & Mallika Mundkur. (2021) Repeated or Continuous Medically Supervised Ketamine Administration Associated with Hepatobiliary Adverse Events: A Retrospective Case Series. Drug Safety 44:12, pages 1365-1374.
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John Martin Corkery, Wan-Chu Hung, Hugh Claridge, Christine Goodair, Caroline S Copeland & Fabrizio Schifano. (2021) Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997–2019. Journal of Psychopharmacology 35:11, pages 1324-1348.
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Monique van Velzen, Jack D.C. Dahan, Eveline L.A van Dorp, Jeffrey S. Mogil, Carlijn R. Hooijmans & Albert Dahan. (2021) Efficacy of ketamine in relieving neuropathic pain: a systematic review and meta-analysis of animal studies. Pain 162:9, pages 2320-2330.
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Chui C. Chong & Stephan A. Schug. (2021) Efficacy and Tolerability of Oral Compared with Sublingual Ketamine Lozenges as Rescue Analgesics in Adults for Acute Pain: The OSKet Trial. Clinical Drug Investigation 41:9, pages 817-823.
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Immaculate M. Langmia, Katja S. Just, Sabrina Yamoune, Jürgen Brockmöller, Collen Masimirembwa & Julia C. Stingl. (2021) CYP2B6 Functional Variability in Drug Metabolism and Exposure Across Populations—Implication for Drug Safety, Dosing, and Individualized Therapy. Frontiers in Genetics 12.
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Asbjørn Mohr Drewes, Louise Kuhlman, Trine Andresen & Søren Schou Olesen. 2021. Clinical Pancreatology for Practising Gastroenterologists and Surgeons. Clinical Pancreatology for Practising Gastroenterologists and Surgeons 273 282 .
G. Mion. (2021) Pharmacologie de la kétamine. Douleur et Analgésie 34:1, pages 3-15.
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Matthew B. Phillips, Aparna Nigam & Jon W. Johnson. (2020) Interplay between Gating and Block of Ligand-Gated Ion Channels. Brain Sciences 10:12, pages 928.
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Albert Dahan, Monique van Velzen & Marieke Niesters. (2020) Ketamine for neuropathic pain: a tiger that won't bite?. British Journal of Anaesthesia 125:3, pages e275-e276.
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Martina Rekatsina, Antonella Paladini, Alba Piroli, Panagiotis Zis, Joseph V. Pergolizzi & Giustino Varrassi. (2020) Pathophysiologic Approach to Pain Therapy for Complex Pain Entities: A Narrative Review. Pain and Therapy 9:1, pages 7-21.
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Christoph Czarnetzki, Jules Desmeules, Enrico Tessitore, Antonio Faundez, Jocelyne Chabert, Youssef Daali, Roxane Fournier, Elise Dupuis‐Lozeron, Christine Cedraschi & Martin Richard Tramèr. (2019) Perioperative intravenous low‐dose ketamine for neuropathic pain after major lower back surgery: A randomized, placebo‐controlled study. European Journal of Pain 24:3, pages 555-567.
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André Schwertner, Maxciel Zortea, Felipe Vasconcelos Torres, Leticia Ramalho, Camila Fernanda da Silveira Alves, Guilherme Lannig, Iraci L. S. Torres, Felipe Fregni, Gustavo Gauer & Wolnei Caumo. (2019) S-Ketamine’s Effect Changes the Cortical Electrophysiological Activity Related to Semantic Affective Dimension of Pain: A Placebo- Controlled Study in Healthy Male Individuals. Frontiers in Neuroscience 13.
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Vwaire Orhurhu, Mariam Salisu Orhurhu, Anuj Bhatia & Steven P. Cohen. (2019) Ketamine Infusions for Chronic Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesthesia & Analgesia 129:1, pages 241-254.
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Mohammed H. Elkomy, Nabil Alruwaili, Mohammed Elmowafy, Khaled Shalaby, David R. Drover & Chandra Ramamoorthy. (2019) Assessment of Ketamine Adult Anesthetic Doses in Pediatrics Using Pharmacokinetic Modeling and Simulations. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy 39:4, pages 454-462.
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Yury Khelemsky & Mourad M. Shehabar. 2019. Essentials of Interventional Cancer Pain Management. Essentials of Interventional Cancer Pain Management 353 360 .
Gisèle Pickering, Véronique Morel & Joelle Micallef. (2018) Kétamine et douleur chronique : une revue narrative de son efficacité et sécurité. Therapies 73:6, pages 529-539.
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Tony Ye, Mitchell J. Bartlett, Matthew B. Schmit, Scott J. Sherman, Torsten Falk & Stephen L. Cowen. (2018) Ten-Hour Exposure to Low-Dose Ketamine Enhances Corticostriatal Cross-Frequency Coupling and Hippocampal Broad-Band Gamma Oscillations. Frontiers in Neural Circuits 12.
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Steven P. Cohen, Anuj Bhatia, Asokumar Buvanendran, Eric S. Schwenk, Ajay D. Wasan, Robert W. Hurley, Eugene R. Viscusi, Samer Narouze, Fred N. Davis, Elspeth C. Ritchie, Timothy R. Lubenow & William M. Hooten. (2018) Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Regional Anesthesia and Pain Medicine, pages 1.
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André Schwertner, Maxciel Zortea, Felipe V. Torres & Wolnei Caumo. (2018) Effects of Subanesthetic Ketamine Administration on Visual and Auditory Event-Related Potentials (ERP) in Humans: A Systematic Review. Frontiers in Behavioral Neuroscience 12.
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D. Michelet, C. Brasher, A.‐L. Horlin, M. Bellon, F. Julien‐Marsollier, T. Vacher, S. Pontone & S. Dahmani. (2017) Ketamine for chronic non‐cancer pain: A meta‐analysis and trial sequential analysis of randomized controlled trials. European Journal of Pain 22:4, pages 632-646.
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Zirong Zhao & Doris K. Cope. 2018. Handbook of Pain and Palliative Care. Handbook of Pain and Palliative Care 507 545 .
Kelly Jonkman, Tine van de Donk & Albert Dahan. (2017) Ketamine for cancer pain: what is the evidence?. Current Opinion in Supportive & Palliative Care 11:2, pages 88-92.
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Tracy Ann Pasek, Kelli Crowley, Catherine Campese, Rachel Lauer & Charles Yang. (2017) Case Study of High-Dose Ketamine for Treatment of Complex Regional Pain Syndrome in the Pediatric Intensive Care Unit. Critical Care Nursing Clinics of North America 29:2, pages 177-186.
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Kelly Jonkman, Albert Dahan, Tine van de Donk, Leon Aarts, Marieke Niesters & Monique van Velzen. (2017) Ketamine for pain. F1000Research 6, pages 1711.
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Xuefeng Wang & Shichuo Li. 2017. Refractory Status Epilepticus. Refractory Status Epilepticus 197 246 .
Anne Berquin & Jacques Grisart. 2016. Les défis de la douleur chronique. Les défis de la douleur chronique 515 562 .
Nalini Vadivelu, Erika Schermer, Vijay Kodumudi, Kumar Belani, RichardD Urman & AlanDavid Kaye. (2016) Role of ketamine for analgesia in adults and children. Journal of Anaesthesiology Clinical Pharmacology 32:3, pages 298.
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Linda C.J. Oudejans, Monique van Velzen & Albert Dahan. 2016. Neuropathology of Drug Addictions and Substance Misuse. Neuropathology of Drug Addictions and Substance Misuse 541 550 .
Valeria Martinez, Benoit Derivaux & Helene Beloeil. (2015) Ketamine for pain management in France, an observational survey. Anaesthesia Critical Care & Pain Medicine 34:6, pages 357-361.
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Plato Mak, Jillian H. Broadbear, Anton Kolosov & Colin S. Goodchild. (2015) Long-Term Antihyperalgesic and Opioid-Sparing Effects of 5-Day Ketamine and Morphine Infusion (“Burst Ketamine”) in Diabetic Neuropathic Rats. Pain Medicine 16:9, pages 1781-1793.
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Yibai Li, Kate A. Jackson, Barry Slon, Janet R. Hardy, Michael Franco, Leeroy William, Peter Poon, Janet K. Coller, Mark R. Hutchinson, David C. Currow & Andrew A. Somogyi. (2015) CYP2B6 * 6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects . British Journal of Clinical Pharmacology 80:2, pages 276-284.
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F. Marchetti, A. Coutaux, A. Bellanger, C. Magneux, P. Bourgeois & G. Mion. (2015) Efficacy and safety of oral ketamine for the relief of intractable chronic pain: A retrospective 5-year study of 51 patients. European Journal of Pain 19:7, pages 984-993.
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J. Juel, S. S. Olesen, A. E. Olesen, J. L. Poulsen, A. Dahan, O. Wilder-Smith, A. Madzak, J. B. Frokjaer & A. M. Drewes. (2015) Study protocol for a randomised, double-blinded, placebo-controlled, clinical trial of S-ketamine for pain treatment in patients with chronic pancreatitis (RESET trial). BMJ Open 5:3, pages e007087-e007087.
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Xiao‐Feng Xiong, Mette H. Poulsen, Rama A. Hussein, Niels G. Nørager & Kristian Strømgaard. (2014) Structure–Activity Relationship Study of Spider Polyamine Toxins as Inhibitors of Ionotropic Glutamate Receptors. ChemMedChem 9:12, pages 2661-2670.
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L. Ashley Blackshaw, Dmitry S. Bordin, Christina Brock, Anne Brokjaer, Asbjørn Mohr Drewes, Adam D. Farmer, Anne Lund Krarup, Christian Lottrup, Antonina A. Masharova, Fouad J. Moawad & Anne Estrup Olesen. (2014) Pharmacologic treatments for esophageal disorders. Annals of the New York Academy of Sciences 1325:1, pages 23-39.
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Keith G. Rasmussen. (2013) Psychiatric side effects of ketamine in hospitalized medical patients administered subanesthetic doses for pain control. Acta Neuropsychiatrica 26:4, pages 230-233.
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Jana Sawynok. (2014) Topical and Peripheral Ketamine as an Analgesic. Anesthesia & Analgesia 119:1, pages 170-178.
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Roisin Bevan & Denis Burke. (2014) Ketamine as a possible cause of cirrhosis in a patient with chronic pain: Table 1. Frontline Gastroenterology 5:3, pages 208-210.
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Jamie Sleigh, Martyn Harvey, Logan Voss & Bill Denny. (2014) Ketamine – More mechanisms of action than just NMDA blockade. Trends in Anaesthesia and Critical Care 4:2-3, pages 76-81.
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Alzbeta Juven-Wetzler, Hagit Cohen, Zeev Kaplan, Avi Kohen, Oren Porat & Joseph Zohar. (2014) Immediate ketamine treatment does not prevent posttraumatic stress responses in an animal model for PTSD. European Neuropsychopharmacology 24:3, pages 469-479.
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Anthony E. Pickering & Candida S. McCabe. (2014) Prolonged ketamine infusion as a therapy for complex regional pain syndrome: synergism with antagonism?. British Journal of Clinical Pharmacology 77:2, pages 233-238.
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Marieke Niesters, Christian Martini & Albert Dahan. (2014) Ketamine for chronic pain: risks and benefits. British Journal of Clinical Pharmacology 77:2, pages 357-367.
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Diogo R. Lara, Luisa W. Bisol & Luciano R. Munari. (2013) Antidepressant, mood stabilizing and procognitive effects of very low dose sublingual ketamine in refractory unipolar and bipolar depression. International Journal of Neuropsychopharmacology 16:9, pages 2111-2117.
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Maarten Swartjes, Marieke Niesters, Lara Heij, Ann Dunne, Leon Aarts, Carla Cerami Hand, Hyung-Suk Kim, Michael Brines, Anthony Cerami & Albert Dahan. (2013) Ketamine Does Not Produce Relief of Neuropathic Pain in Mice Lacking the β-Common Receptor (CD131). PLoS ONE 8:8, pages e71326.
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Rosemary C. Polomano, Chester C. BuckenmaierIIIIII, Kyung H. Kwon, Alexandra L. Hanlon, Christine Rupprecht, Cynthia Goldberg & Rollin M. Gallagher. (2013) Effects of Low-Dose IV Ketamine on Peripheral and Central Pain from Major Limb Injuries Sustained in Combat. Pain Medicine 14:7, pages 1088-1100.
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Georges Mion & Thierry Villevieille. (2013) Ketamine Pharmacology: An Update ( Pharmacodynamics and Molecular Aspects, Recent Findings ) . CNS Neuroscience & Therapeutics 19:6, pages 370-380.
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M. Niesters, L. Aarts, E. Sarton & A. Dahan. (2013) Influence of ketamine and morphine on descending pain modulation in chronic pain patients: a randomized placebo-controlled cross-over proof-of-concept study. British Journal of Anaesthesia 110:6, pages 1010-1016.
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Chaoxuan Dong & K.J.S. Anand. (2013) Developmental neurotoxicity of ketamine in pediatric clinical use. Toxicology Letters 220:1, pages 53-60.
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John R. Richards & Rachel E. Rockford. (2013) Low-dose ketamine analgesia: patient and physician experience in the ED. The American Journal of Emergency Medicine 31:2, pages 390-394.
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Marieke Niesters, Maarten Swartjes, Lara Heij, Michael Brines, Anthony Cerami, Ann Dunne, Elske Hoitsma & Albert Dahan. (2013) The erythropoietin analog ARA 290 for treatment of sarcoidosis-induced chronic neuropathic pain. Expert Opinion on Orphan Drugs 1:1, pages 77-87.
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G. Mion. (2012) Ketamina. EMC - Anestesia-Rianimazione 17:4, pages 1-11.
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G. Mion. (2012) Ketamina. EMC - Anestesia-Reanimación 38:4, pages 1-13.
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G. Mion. (2012) Kétamine. EMC - Anesthésie-Réanimation 9:3, pages 1-12.
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Helen Slater, Thomas Graven-Nielsen, Anthony Wright & Stephan A. Schug. (2012) Low-Dose Sublingual Ketamine Does Not Modulate Experimentally Induced Mechanical Hyperalgesia in Healthy Subjects. Pain Medicine 13:9, pages 1235-1246.
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Pierre Blier, Daniel Zigman & Jean Blier. (2012) On the Safety and Benefits of Repeated Intravenous Injections of Ketamine For Depression. Biological Psychiatry 72:4, pages e11-e12.
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Rae F. Bell. (2012) Ketamine for chronic noncancer pain. Current Opinion in Supportive & Palliative Care 6:2, pages 183-187.
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Sanjay J. Mathew, Asim Shah, Kyle Lapidus, Crystal Clark, Noor Jarun, Britta Ostermeyer & James W. Murrough. (2012) Ketamine for Treatment-Resistant Unipolar Depression. CNS Drugs 26:3, pages 189-204.
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Laura Kranaster, Jutta Kammerer-Ciernioch, Carolin Hoyer & Alexander Sartorius. (2011) Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study. European Archives of Psychiatry and Clinical Neuroscience 261:8, pages 575-582.
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Ingeborg Noppers, Marieke Niesters, Maarten Swartjes, Martin Bauer, Leon Aarts, Natasja Geleijnse, René Mooren, Albert Dahanl & Elise Sarton. (2011) Absence of long-term analgesic effect from a short-term S-ketamine infusion on fibromyalgia pain: A randomized, prospective, double blind, active placebo-controlled trial. European Journal of Pain 15:9, pages 942-949.
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John W. Sear. (2011) Ketamine hepato-toxicity in chronic pain management: Another example of unexpected toxicity or a predicted result from previous clinical and pre-clinical data?. Pain 152:9, pages 1946-1947.
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Ingeborg M. Noppers, Marieke Niesters, Leon P.H.J. Aarts, Martin C.R. Bauer, Asbjørn M. Drewes, Albert Dahan & Elise Y. Sarton. (2011) Drug-induced liver injury following a repeated course of ketamine treatment for chronic pain in CRPS type 1 patients: A report of 3 cases. Pain 152:9, pages 2173-2178.
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Mary-Ann Fitzcharles & Yoram Shir. (2011) Management of Chronic Pain in the Rheumatic Diseases with Insights for the Clinician. Therapeutic Advances in Musculoskeletal Disease 3:4, pages 179-190.
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