Background The authors examined the interaction of ketamine with recombinant mu, kappa, and delta opioid receptors and recombinant orphan opioid receptors expressed in Chinese hamster ovary cells (CHO-mu, CHO-kappa, CHO-delta, and CHOORL1, respectively). Methods: CHO-mu, CHO-kappa, and CHO-delta membranes were incubated with the opioid receptor radioligand [H-3]diprenorphine at room temperature. Ketamine (racemic, R(-) and S(+)) was included at concentrations covering the clinical range. CHOORL1 membranes were incubated with [I-125]Tyr(14) nociceptin and racemic ketamine at room temperature. The effects of racemic ketamine and selective opioid receptor agonists (mu: [D-Ala(2), MePhe(4), Gly(ol)(5)] enkephalin (DAMGO); kappa: spiradoline or delta: [D-pen(2), D-pen(5)] enkephalin (DPDPE)) on forskolin-stimulated cyclic adenosine monophosphate formation also were examined. Data are mean + SEM. Results: Racemic ketamine increased the radioligand equilibrium dissociation constant for [H-3]diprenorphine from 85 +/- 5 to 273 +/- 11, 91 +/- 6 to 154 +/- 16, and 372 +/- 15 to 855 +/- 42 pM in CHO-mu, CHO-kappa, and CHO-delta, respectively. The concentration of radioligand bound at saturation was unaffected. In CHO-mu and CHO-kappa cells, racemic ketamine did not slow the rate of naloxone-induced [H-3]diprenorphine dissociation. Ketamine and its isomers also displaced [H-3]diprenorphine binding to mu, kappa, and delta receptors in a dose-dependent manner, with pK(i) values for racemic ketamine of 4.38 +/- 0.02, 4.55 +/- 0.04, and 3.57 +/- 0.02, respectively. SCC) -ketamine was two to three times more potent than R(-)-ketamine at mu and kappa receptors, Racemic ketamine displaced [I-125]Tyr(14)nociceptin with an estimated affinity constant of 0.5 mM. Racemic ketamine inhibited the formation of cyclic adenosine monophosphate (naloxone insensitive) in a dose-dependent manner (concentration producing 50% inhibition similar to 2 mM) in all cell Lines, including untransfected CHO cells. Ketamine (100 mu M) reversed DAMGO (mu) and spiradoline (kappa) inhibition of formation of cyclic adenosine monophosphate. Conclusions: Ketamine interacts stereoselectively with recombinant mu and kappa opioid receptors.