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While its ability to influence multiple pathways of repair is supported by compelling preclinical data, the absence of high-quality human trials, the FDAs strict regulatory stance, and the risk of contamination from unregulated sources raise serious safety and legal concerns (including malpractice concerns and fines)

381,382 Furthermore, by inhibiting NMDARs, ketamine can reduce the excitation of specific cortical GABAergic interneurons, resulting in a temporary increase in glutamate release that stimulates postsynaptic AMPA glutamate receptors

NCs are present during early NP development and persist in the adult NP tissue [27, 29, 30]

10.1111/j.1365-2443.2007.01153.x 85

Trials showed significant increases in GH release and growth velocity at 6 months, with efficacy reported through 36 months