Ketamine appears to stimulate the cardiovascular system, producing changes in the heart rate and blood pressure. As such, tachycardia is one of the most common symptoms identified in recreational users. Findings of neurotoxicity in animal studies have raised concerns on the consumption of ketamine by recreational users, for a number of reasons: unlike when it is clinically administered, substance users will not take ketamine in combination with protective agents. Moreover, substances which may increase the neurotoxic potency of ketamine might be co-administered (including PCP, tiletamine as well as alcohol). Furthermore, recreational use usually implies repeated exposure, whereas clinical use is mostly incidental.
Side effects related to the use of ketamine in conjunction with other drugs include hypertension and pulmonary oedema. Psychological dependence in some users has also been identified. Adverse effects in long-term users of ketamine have been reported albeit scarce. These included persistent impairment of attention and recall, and a subtle visual anomaly. Other reported effects include anxiety, changes of perception, an impairment of motor function and rhabdomyolysis.
Between 1987 and 2000, 12 fatal cases in which ketamine generic viagra pharmacy order amoxicillin medication phentermine 37.5mg was identified were reported, but only three of them involved ketamine alone. Chronic ketamine use has been reported to result in potential lasting memory and cognitive dysfunction.
There is very limited information on the PCP analogues. Acute PCP intoxication results in a wide range of behavioural/psychological effects, from mild neurologic and physiologic abnormalities, stupor or light coma to deep coma. Manifestations of behavioural toxicity resemble psychiatric syndromes. PCP has also been claimed to cause violent behaviour.
References Jansen, K.L., ‘Ketamine - Can chronic use impair memory?’, International Journal of the Addictions, 1990, 25, 133-139, in World Health Organization, ‘WHO Expert Committee on Drug Dependence. Thirty- fifth Meeting’, 2012  Okon, T., a case based review ‘Ketamine: an introduction for the pain and palliative medicine physician’, Pain Physician, 2007, 10, 493-500  Gorelick, D.A. and Balster, R.L., ‘Phencyclidine (PCP)’, in F.E. Bloom & R.L. Kupfer (Eds.), Psychopharmacology: The fourth generation of progress, New York, 1995, 1767-76; Brecher, M., Wang B.W., Wong, H. and Morgan, J.P., ‘Phencyclidine and violence: clinical and legal issues’, Journal of Clinical Psychopharmacology, 1988, 8 (6), 397-401; Daghestani, A.N. and Schnoll, S.H., ‘Phencyclidine abuse and dependence’, Treatments of Psychiatric Disorders: A task force report of the American Psychiatric Association, American Psychiatric Association, Washington D.C., 1989, 1209-18
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