The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
As ketamine has emerged as a treatment for certain forms of depression, it has become clear that it works through several different mechanisms, including changing the amount of inhibition in the brain and rewiring neural circuits.
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Bookmarking — the dossier-vs-overview split is the right call. Most of the time I want overview; sometimes I want receipts.
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ketamine binds to and blocks that nmda receptor so the obvious conclusion would be that ketamine prevents neuroplasticity and that's not what happens we know that ketamine actually induces neuroplasticity and it does so specifically in the brain circuits that control mood the net consequence being improvements in mood
it happens because ketamine binds to and blocks those nmda receptors on inhibitory neurons the inhibitory neurons are the neurons that normally suppress the activity of other neurons so when ketamine binds to the nmda receptor the activity of those inhibitory neurons is reduced and as a consequ quence excitatory communication between neurons in those mood related circuits increases and it increases in a way that recruits neuroplasticity that strengthens those connections and makes them more likely to be active in the future
now it is not the case at least at clinical doses that ketamine induces seizures it certainly can at higher doses but at clinical doses when ketamine supresses the activity of those inhibitory neurons and the excitatory neurons ramp up their activity they're ramping up activity a lot and enough to create changes in those neural circuits associated with mood and the changes are in the direction of making those neural circuits more likely to generate positive mood and less likely to generate negative mood
ketamine blocks that nmda receptor and there's the conundrum I keep coming back to which is you need neuroplasticity in order to get relief from depression so what researchers have discovered is that yes ketamine blocks the nmda receptor it actually quiets down neurons it prevents neurons from being as active as they normally would be and yet somehow almost paradoxically it increases neuroplasticity in brain circuits that are involved in mood in reward in self-reflection
ketamine has this incredible property it can literally change the neural circuits that generate mood that generate your feelings of well-being but it does so through a somewhat convoluted pathway right it blocks the receptor that everyone thinks is involved in neuroplasticity and in doing so it actually creates neuroplasticity