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S-isomer Ketamine
Is a racemic combination of R- and S-ketamine, often known as ketamine. Compared to R-ketamine, S-isomer ketamine exhibits stronger analgesic and anesthetic effects and a lower risk of psychotomimetic and other side effects. As a result, there is growing support for using S-ketamine rather than racemic ketamine for anesthesia or analgesia. The preclinical and clinical research on S-ketamine’s antidepressant effects is reviewed in this article.
Research on animals points to possible benefits of R-ketamine over S-ketamine. According to case reports, case series, and a few small randomized controlled trials, patients with medication-refractory depression may benefit from single or repeated intravenous infusions of S-ketamine (0.2–0.4 mg/kg) or intranasal administrations (28–84 mg). The benefits observed are comparable in size to those associated with racemic ketamine.
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