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cover of episode Ketamine: Benefits and Risks for Depression, PTSD & Neuroplasticity

Ketamine: Benefits and Risks for Depression, PTSD & Neuroplasticity

2023/8/7
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Huberman Lab

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安德鲁·休伯曼
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安德鲁·休伯曼:本期节目探讨了可待因作为一种药物的双重性,既有其在治疗抑郁症、创伤后应激障碍(PTSD)等精神疾病中的临床益处,也存在滥用成瘾的风险。节目深入探讨了可待因的作用机制,包括其对神经递质系统(如谷氨酸和内源性阿片类物质通路)的影响,以及其如何诱导解离状态和欣快感。此外,节目还比较了可待因的不同给药途径、剂量和形式,并讨论了微剂量可待因的有效性以及娱乐性可待因使用的潜在风险(包括俗称的“K-hole”)。通过对神经可塑性和脑源性神经营养因子(BDNF)的讨论,节目阐明了可待因如何改变大脑神经环路,从而缓解抑郁症状。节目强调,可待因的即时效应和长期临床益处可能并非直接相关,抗抑郁行为在治疗中也扮演着重要角色。

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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).

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Timestamps

(00:00:00) Ketamine

(00:02:46) Sponsors: LMNT & Waking Up

(00:05:13) Ketamine & PCP; Clinical & Recreational Use

(00:09:00) Depression & Current Treatments

(00:15:17) Preclinical Models of Depression & Ketamine; “Learned Helplessness” 

(00:22:11) Ketamine & Clinical Uses; Depression & Suicidality 

(00:28:32) Ketamine & Other Psychiatric Challenges; Relief & Durability 

(00:33:40) Sponsor: AG1 (Athletic Greens)

(00:34:29) NMDA Receptor & Neuroplasticity

(00:41:36) Excitatory & Inhibitory Communication, Seizure, NMDA Receptors & Ketamine

(00:48:26) How Ketamine Functions in Brain; Acute & Long-Term Effects

(00:55:36) Brain-Derived Neurotrophic Factor (BDNF) & Ketamine Therapy

(01:03:40) Ketamine & Opioid Pathway 

(01:10:00) Divergent Mechanisms of Immediate & Long-Term Effects

(01:15:45) Habenula, Pro-Depressive Behaviors & Ketamine Therapy

(01:20:36) Ketamine & Context-Dependent Strategy; Reward Pathway

(01:22:45) Dissociative States

(01:26:04) Doses & Routes of Administration; “K-holes”; Risk & Caution

(01:32:25) Ketamine Forms; R-, S- vs R/S- Ketamine; Micro-Dosing

(01:38:24) Ketamine: Effects & Therapy

(01:40:40) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Social Media, Neural Network Newsletter

Title Card Photo Credit: Mike Blabac)

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