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These risks are not theoretical possibilities but actual documented cases that have appeared in medical literature

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In a recent double-blind crossover clinical study, pretreatment with the opioid receptor antagonist naltrexone significantly attenuated the antidepressant and antisuicidal effects of a single ketamine dose in 12 adults with treatment-resistant depression 20,21 , suggesting opioid system activation may be required for ketamines antidepressant effects

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