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Ketamine: Benefits and Risks for Depression, PTSD & Neuroplasticity

Episode 136 Aug 7, 2023 1h 39m 13 insights
In this episode, I explain how ketamine causes rewiring of brain circuits and dissociative states to relieve symptoms of depression and post-traumatic stress disorder (PTSD). I explain how ketamine impacts both the brain’s glutamate and its endogenous opioid pathways, which together regulate mood and well-being. I discuss how ketamine therapy is used clinically to treat major depression, bipolar depression, obsessive-compulsive disorder (OCD), suicidality and other psychiatric challenges. I also describe how ketamine causes the subjective effects of dissociation and euphoria and, at higher doses, is an anesthetic. I compare the different routes of ketamine administration, dosages and forms of ketamine, and if micro-dosing ketamine is effective. I also highlight the potential risks of recreational ketamine use (and the colloquial term ‘K-holes’). This episode should interest anyone interested in ketamine, treatments for depression, neuroplasticity mechanisms, psychiatry and mental health. For show notes, including referenced articles and additional resources, please visit hubermanlab.com. Use Ask Huberman Lab, our new AI-powered platform, for a summary, clips, and insights from this episode.
Actionable Insights

1. Integrate Antidepressive Behaviors

For lasting mental health benefits from drug treatments, actively engage in ‘antidepressive behaviors’ such as morning sunlight, quality sleep, proper nutrition, and social engagement to reinforce positive neural changes.

2. Prioritize Foundational Mental Health

Support mental health by consistently viewing morning sunlight, ensuring regular and sufficient quality sleep, maintaining proper nutrition, and engaging in proper social interactions.

3. Reinforce Neural Changes Actively

To maximize benefits from treatments, actively seek stimulating work, social engagement, and comprehensive self-care, as neural circuits respond to these specific patterns of thinking and behavior.

4. Avoid Nighttime Blue Light

Refrain from viewing blue light between 11 p.m. and 4 a.m. to prevent activation of a pro-depressive circuit that lowers dopamine and increases cortisol.

5. Hydrate with Electrolytes Daily

Dissolve one packet of Element in 16-32 ounces of water and drink it first thing in the morning, and also during any physical exercise, to maintain optimal hydration and electrolyte balance.

6. Restore Energy with NSDR

Utilize yoga nidra or Non-Sleep Deep Rest (NSDR) protocols for short 10-minute sessions to significantly restore levels of cognitive and physical energy.

7. Use Ketamine Clinically

If considering ketamine for treatment, ensure its use is strictly within an appropriate clinical context, adhering to prescribed dosages and frequency, due to its high potential for abuse and associated risks.

8. Caution: Ketamine Outside Clinic

Understand that taking prescribed ketamine outside of a clinical setting carries significant risks, including potential for recreational abuse and addiction.

9. Avoid Ketamine K-hole Doses

Do not take ketamine at doses that induce a ‘K-hole’ (full-blown anesthesia), as this state can be dangerous and potentially deadly, particularly when combined with other drugs such as barbiturates or alcohol.

10. Ketamine & Seizure Risk

Individuals who are seizure-prone, whether due to epilepsy, prior head injury, or unknown predisposition, should avoid ketamine due to its potential to induce seizures by disrupting brain inhibition.

11. Avoid Driving on Ketamine

As ketamine is a sedative, exercise extreme caution and avoid activities such as driving or walking in traffic while under its influence.

12. No Ketamine Microdosing for Depression

Avoid microdosing ketamine for the treatment of depression, as current scientific and clinical literature provides no evidence of its effectiveness at such doses.

13. Understand Ketamine’s Dual Effects

Recognize that ketamine produces both immediate subjective effects like dissociation and euphoria, as well as long-term changes in neural circuitry, regardless of clinical or recreational use.