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. 2023 May 12;16(5):742. doi: 10.3390/ph16050742

Figure 1.

Figure 1

Intermediates in the metabolism of ketamine enantiomers. Cytochrome P450 (CYP) enzymes in the liver N-demethylate ketamine or hydroxyketamine to produce norketamine or hydroxynorketamine, respectively. The oxidation of norketamine to produce dehydronorketamine also occurs. CYP enzymes can hydroxylate ketamine and norketamine to produce hydroxyketamine and hydroxynorketamine, respectively. (A) depicts the metabolism of (S)-ketamine (esketamine), while (B) depicts the metabolism of (R)-ketamine (arketamine). All structures are derived from the PubChem database (https://pubchem.ncbi.nlm.nih.gov/, accessed on 3 May 2023). The overall figure is adapted from [72,73].