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The FDA-approved rapid antidepressant and legal psychoplastogen.
Ketamine is a Schedule III controlled substance, legally available by prescription. It works by blocking NMDA receptors, triggering a glutamate surge that rapidly boosts BDNF and builds new synapses.
Blocks glutamate receptors → Disrupts default mode network
Paradoxical increase in glutamate at AMPA receptors
Rapid increase in Brain-Derived Neurotrophic Factor
New synaptic connections form within hours
| Route | Dose | Setting | Cost | Notes |
|---|---|---|---|---|
| IV Infusion | 0.5mg/kg | Clinic | $400-800 | Gold standard, 100% bioavail. |
| Spravato (Esketamine) | 56-84mg | Clinic | $600-900 | FDA-approved, Insurance covered |
| IM Injection | 0.5-1mg/kg | Clinic | $300-500 | Faster onset than IV |
| Oral Troche | 100-300mg | At-home (Rx) | $100-200 | Low bioavail (~20%) |
Application-resistant depression
Antidepressant effects begin
Reduction within 24 hours
Krystal JH, et al. • World Psychiatry (2019)
Key Finding: Comprehensive review of Ketamine's mechanism and efficacy for TRD.
Zarate CA Jr, et al. • Arch Gen Psychiatry (2006)
Key Finding: Landmark study demonstrating rapid antidepressant effects within 2 hours.
Fava M, et al. • American Journal of Psychiatry (2020)
Key Finding: Double-blind study confirming efficacy of IV Ketamine.