Rankings / Cognitive — Nootropics
Ketamine
Cognitive · NMDA antagonist
Tier B-
What this is
Paradigm-shifting for TRD since Berman 2000 and Zarate 2006. Telehealth ketamine programs exploded 2020-2024 with questionable oversight; bladder damage from chronic use well-documented. Recreational use and 'K-hole' highly dissociative. Matthew Perry death from ketamine overdose October 2023.
Mechanism
Non-competitive NMDA receptor antagonist; also mu-opioid, dopaminergic, cholinergic activity; rapid-onset antidepressant; S-enantiomer (esketamine/Spravato) FDA-approved for TRD 2019
Dose & route
0.5 mg/kg IV over 40 min (depression); 40-85 mg intranasal esketamine
Citations
- https://pubmed.ncbi.nlm.nih.gov/16894061/
- https://pubmed.ncbi.nlm.nih.gov/30715137/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6513787/
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This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.