Introduction

During its meeting in September 2002, the WHO Expert Committee on Drug Dependence did

a pre-review on ketamine (WHO, 2003). Based on the available information a recommendation was given for a Critical Review of this substance. In about the same period

both in The Netherlands (CAM, 2002) as well in The European Union (EMCDDA, 2002) separate Risk Assessment procedures for Ketamine for sale were performed, concluding that there was no need to tighten the current systems for control of this substance, i.e as a pharmaceutical product.

The information used in the three above mentioned procedures (meanwhile published) has been the starting point for this Critical Review Report. A review of pharmacological and toxicological data prepared by Dutch experts (Van Aerts and Van der Laan) has been used (with their permission) for the relevant parts of this Report. In addition to these data, an online computer search has been performed in the following databases Pubmed, Toxline, PsycINFO, and Embase.

Conclusions

Ketamine is an aryl clonal alkylamine structurally related to cyclones, like eticyclidine,phencyclidine, procyclidine, and tenocyclidine Buy meth online.

It is an NMDA-receptor-antagonist used as an anesthetic in both human and veterinary medicine. Furthermore, a number of effects on various neurotransmitter systems have been described.

Ketamine can produce a state of dependence as shown in various animal models. This is supported by some human data as reported by the WHO. Although one should keep in mind that monitoring of adverse effects in patients is quite different from monitoring effects inrecreational users. Due to its pharmacological effects, it produces a depression of the central nervous system, resulting in hallucinations, disturbances in thinking and perception, and also in motor function.

There is evidence that ketamine is abused, but looking at the figures one can hardly consider

this to constitute a public health and social problem. Especially when comparing ketamine to the other cyclones Crystal meth for sale.

The substance is difficult to synthesize, so illegal production is unlikely. Preparations are mainly used in hospitals and veterinary clinics, so it is not expected that diversion will take place on a large scale.

Summarizing all the available information international control is not really necessary, but keeping the drug under surveillance could be considered. 

Proprietary names:

Market, Anasket, Anesketin, Brevinase, Brevinaze, Calypso, Calypsovet, Chlorketam,

Imagine, Inducmina, Kalipsol, Katalar, Keta, Keta-HamelnKetaject, Ketalar, Katalin,

Ketalar, Ketamav, Ketamax, Ketamil, Ketaminol Vet, Ketanarkon, Ketanest, Ketanest-S,

Ketaset, Ketasol, Ketava, Ketaved, Ketavet, Ketamine HCl, Ketolar, Ktmin, Narkamon,

Marketing, Pan-Ketamine, S-Ketamine, Tekam, Vetalar Vetaket, Vetus Ketha-Thesis.

Street names

A number of street names for ketamine can be found in the literature, like: Ketamine, K, KHole, Kaddy, Kate, Ket, Vitamin K, Special K, Super K, Kéta K, Kit Kat, Cat valium, Liquid E, Liquid G, Flatliners, Tac et Tic, Jet, Super acid, 1980 acid, Special LA coke, Super C, Purple, Mauve and Green (EMCDDA, 2002; Nabben and Korf, 2000; Pagliaro and Pagliaro, 2004). Some names clearly refer to the veterinary origin of the product.

Chemistry

Ketamine (2-(2-chlorophenyl)-2-(methylamino)-cyclohexanone) is an aryl cycloalkyl amine structurally related to phencyclidine (PCP). Ketamine hydrochloride is water-soluble, white crystalline and has a pKa of 7.5 (Budavari et al., 1989). Its free base, ketamine, has a lipid solubility 10 times that of thiopentone. The commercially available pharmaceutical form is an aqueous solution for injection of the racemic mixture of the hydrochloride salt. However, in some countries, e.g. the Netherlands the S-enantiomer is marketed. 

 General pharmacology

The pharmacology of ketamine will be described in two parts. The first one dealing with the effects of the substance on various neurotransmitter systems and related to both its clinical use and its use as a recreational agent. The second part dealing with the effects on various organ systems and often wanted in clinical or veterinary practice or occurring during non-medical use and sometimes leading to adverse reactions.