PERSPECTIVE article
Front. Psychiatry
Sec. Psychopharmacology
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1610335
The Collective Lie in Ketamine Therapy: A Call to Realign Clinical Practice with Neurobiology
Provisionally accepted
- 1Scenic City Neurotherapy, Chattanooga, United States
- 2RailRoad Valley Therapeutics, LLC, Chattanooga, United States
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1.Abstract: In recent years, ketamine therapy has become increasingly entangled with psychedelic culture, leading to widespread misinterpretation of its therapeutic mechanism. This manuscript challenges the prevailing narrative that positions ketamine as a consciousness-expanding agent or psychotherapy enhancer, highlighting the discord between this view and ketamine’s well-established neurobiological function as an N-methyl-D-aspartate (NMDA) receptor antagonist that promotes neuroplasticity. Drawing on recent research and clinical data, the article argues that the acute dissociative experience often emphasized in ketamine-assisted psychotherapy (KAP) is neither necessary nor sufficient for therapeutic success. Instead, it describes how meaningful, lasting improvement in mental health outcomes requires plasticity-driven reorganization in the days following ketamine administration, not from insights gleaned during dissociation. By prioritizing subjective experience over biological timing, current KAP practitioners risk distorting memory, reinforcing maladaptive narratives, and undermining the potential of psychoplastogenic treatments. This article calls for a shift toward evidence-based protocols that align clinical practice with neurophysiology, advocating for greater education, standardization, and scientific rigor in ketamine therapy.
Keywords: Ketamine, neuroplasticity, psychoplastogen, Treatment-Resistant Depression (TRD), ketamine-assisted psychotherapy (KAP), NMDA receptor antagonist, Evidence-based psychiatry, Psychedelic therapy
Received: 14 Apr 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Miller, Lopes and McCurdy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Charles Brian Miller, Scenic City Neurotherapy, Chattanooga, United States
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