The Role of NMDA Receptor Antagonists in Chronic Pain

Ketamine is a master modulator that impacts pain from multiple different pathways of course through NMDA receptor antagonism but also at mu and delta opioid receptors serotonin receptors monoaminergic and GABA receptors. By modulating these things within nociceptive neurons as well as cross talk with opioid receptors we have some effect that is more robust in people that are opioid tolerant. This also works through activating descending inhibitory pain pathways and overall can modulate even chronic pain.