A unified model of ketamine's dissociative and psychedelic properties.
J Psychopharmacol December 17, 2022 Miriam Marguilho, Inês Figueiredo, Pedro Castro-Rodrigues 57 citations
Ketamine, an NMDA antagonist used for depression, produces rapid but transient antidepressant effects primarily through acute modulation of reward circuits and a sub-acute increase in neuroplasticity. Its dissociative and psychedelic properties arise from dose- and context-dependent disruption of large-scale functional networks: disruption of the salience network accounts for dissociation, while disruption of the default-mode network accounts for the psychedelic state. In psychedelic-assisted psychotherapy, relaxing high-level beliefs with support may allow revision of pathological self-representation models, with neuroplasticity playing a permissive role. This multi-level account suggests leveraging ketamine's psychedelic properties to enhance long-term benefits.