Safety and tolerance of oral ketamine: A systematic review.
Psychiatry Clin NeurosciMay 30, 2026 (epub)
Nathalia Novaretti, Rebeca Mendes P Pessoa, Jaime Eduardo Cecílio Hallak et al.
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In 30 seconds
This systematic review assessed the safety and tolerability of oral ketamine across various clinical populations, including adults and children. Eighteen randomized controlled trials were analyzed, revealing that while adverse effects were mostly mild and transient, the certainty of evidence regarding long-term safety is low. Notably, serious adverse events were rare.
Key findings
- In depression studies, adverse effects were predominantly mild and transient in 427 participants.
- Pediatric trials reported transient neurological effects without significant safety concerns in 239 participants.
- Higher doses of ketamine were associated with increased rates of dizziness, sedation, and dissociative symptoms.
Why it matters
Understanding the safety and tolerability of oral ketamine is crucial for clinicians considering its use in treatment-resistant depression, chronic pain, and pediatric sedation, especially given the lack of standardized formulations and uncertain long-term safety.