Which symptom includes paranoid thoughts as part of an adverse ketamine reaction?

• A. Trouble expressing thoughts
• B. Paranoid thoughts
• C. Altered consciousness
• D. Enhanced sexual pleasure

Answer: (B)

Ketamine can produce dissociative and psychotomimetic effects, meaning it can create experiences that feel detached from reality and can include paranoid thinking. Paranoid thoughts are a recognizable feature of adverse ketamine reactions because the drug disrupts normal brain signaling (via NMDA receptor antagonism), leading to distorted perceptions, misinterpretations of others’ intentions, and fear-driven ideas.

This makes paranoid thoughts the best match among the options because it directly reflects a paranoid ideation component. The other possibilities describe broader or different phenomena: trouble expressing thoughts points to speech or thought-flow issues; altered consciousness is a general change in awareness; and enhanced sexual pleasure is not a typical adverse ketamine effect.