The Green Light on Ketamine: Considerations for On-Road Safety.

Abstract

Ketamine (2-(2-chlorophenyl)-2-(methylamino) cyclohexanone) is a phenylcyclidine derivative originally developed in the 1960’s as a medication to initiate and maintain optimum anaesthesia in veterinary and paediatric surgery [1]. Ketamine functions as an N-methyl-d-aspartate (NMDA) receptor antagonist, and in low or sub-aesthetic doses, has proven efficacy as an analgesic, sedative, and novel antidepressant [2]. The administration of ketamine reliably produces dose-related deficits in several functional cognitive domains, and the associated psychoactive properties of the substance have been described in some detail [3-5]. Despite this, the impact on translatable facets of neurobehavioural functioning associated with ketamine use, such as driving ability, is not well described, and thus assumptions regarding the implications of the use of this drug on measures of traffic safety are equivocal [6]. Epidemiological studies have noted an increase in both the clinical application and concurrent recreational use of ketamine, and thus effective assessments of both the direct and peripheral effects of this substance are of high clinical importance. Ketamine has been used extensively among clinical settings for its analgesic and anesthetising properties, and emerging research has promoted the use of the substance for its antidepressant effects [7]. Pharmacologically, ketamine acts as a non