A new Cochrane review casts doubt on the value of ketamine and other N-methyl-D-aspartate (NMDA) receptor agonists to relieve chronic noncancer pain.

While ketamine and other NMDA receptor agonists are often prescribed off-label to manage chronic pain conditions such as fibromyalgia, nerve pain, and complex regional pain syndrome, researchers found little convincing evidence of a real benefit and identified an increased risk for side effects such as delusions, delirium, paranoia, nausea, and vomiting.

“Clinicians should know that there is currently no clear evidence supporting use of ketamine for chronic pain. Large-scale, definitive randomized trials are urgently needed to determine benefits, risks, and optimal dosing regimens,” first author Michael Ferraro BSc, BHSc, doctoral candidate

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