{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:36:25Z","timestamp":1793687785335,"version":"4.5.1"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,1,16]],"date-time":"2012-01-16T00:00:00Z","timestamp":1326672000000},"content-version":"vor","delay-in-days":625,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2010,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The analgesic effect of ketamine is primarily based on the antagonism of the\n                    <jats:italic>N<\/jats:italic>\n                    \u2010methyl\u2010\n                    <jats:sc>d<\/jats:sc>\n                    \u2010aspartate (NMDA) receptor. Activation of NMDA receptors may play a crucial role in the pathogenesis of chronic pain. Little formal research has been performed on the efficacy and safety of ketamine in chronic pain, especially concerning long\u2010term oral administration. This review provides an overview of the available clinical data on the use of oral ketamine in chronic pain management. A literature search was performed in MEDLINE, EMBASE and the Cochrane Library, resulting in 22 relevant articles. Because most retrieved articles were of a descriptive nature (e.g. case reports and case series) a quantitative analysis was not possible. There was no consistent dose\u2013response relation. A recommended starting dosage in ketamine\u2010naive patients is 0.5 mg\/kg racemic ketamine or 0.25 mg\/kg S\u2010ketamine as a single oral dose. The dosage is increased by the same amount if required. For a continuous analgesic effect it is usually given 3\u20134 times daily. The injection fluid can be taken orally. When parenteral ketamine is switched to oral administration the daily dosage can be kept equal and, depending on clinical effect and\/or adverse effects, is slowly increased. The pharmacologically active metabolite norketamine is believed to contribute to the analgesic effect of oral ketamine. Lack of evidence regarding efficacy, and the poor safety profile, do not support routine use of oral ketamine in chronic pain management. Oral ketamine may have a limited place as add\u2010on therapy in complex chronic pain patients if other therapeutic options have failed.\n                  <\/jats:p>","DOI":"10.1016\/j.ejpain.2009.09.005","type":"journal-article","created":{"date-parts":[[2009,10,30]],"date-time":"2009-10-30T04:36:59Z","timestamp":1256877419000},"page":"466-472","source":"Crossref","is-referenced-by-count":145,"title":["Use of oral ketamine in chronic pain management: A review"],"prefix":"10.1002","volume":"14","author":[{"given":"Maren I.","family":"Blonk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte G.","family":"Koder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia M.L.A.","family":"van den Bemt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J.P.M.","family":"Huygen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/77.5.625"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/J354v21n01_04"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(03)00072-1"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00120-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/026921639601000309"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00123-V"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jps.2600710516"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2007.00314.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(97)01116-3"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181685014"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/eujp.1999.0154"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199708000-00043"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00182-E"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00011-1"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00018-4"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(00)00213-X"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00393-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2000.00018.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03017431"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/53.8.805"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00117-7"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000086618.28845.9B"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199409000-00011"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbb.2008.05.011"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2008.01602.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00373-6"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200206000-00034"},{"key":"e_1_2_7_29_1","unstructured":"Ketanest\u2010S5 solution for injection 5mg\/ml Summary of product characteristics. 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