Ketamine-Induced Syndrome of Inappropriate Antidiuretic Hormone Secretion: A Case Report

Abstract

Ketamine is a phencyclidine-derived dissociative anaesthetic used in the UK currently for the Induction and maintenance of anaesthesia for procedures and diagnostic manoeuvrers. The prevalence of ketamine misuse in England and Wales was at an all-time high in 2019 - 2020, at 0.8%.^[1] The younger age group (16 to 24 years of age) seems to be the most avid users: 3.2% of them used ketamine in that period. Despite its clinical utility, ketamine possesses a significant potential for abuse and dependence, which may precipitate a spectrum of adverse outcomes, including neurotoxicity, psychiatric disturbances, multisystem dysfunction, and alterations in biochemical homeostasis. This report is based on the case of a 30-year-old healthy male who developed severe hyponatremia, confusion, and seizures following recreational ketamine use. Laboratory findings confirmed SIADH, and the patient was treated successfully with fluid restriction and hypertonic saline. This case highlights the potential of ketamine to disrupt water and sodium balance, through central mechanisms involving ADH dysregulation. Clinicians should consider ketamine as a possible cause of acute hyponatremia, especially given its increasing medical and recreational use.