The neurophysiology of ketamine: an integrative review

• Published in: Reviews in the neurosciences Vol. 31; no. 5; pp. 457 - 503
• Main Authors: McMillan, Rebecca, Muthukumaraswamy, Suresh D.
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 01.07.2020; Walter de Gruyter GmbH
• Subjects: Acute effects; Anesthesia; depression; EEG; Electrophysiology; functional magnetic resonance imaging; Ketamine; Magnetic resonance imaging; Neuroimaging; neuropharmacology; Neurophysiology; Positron emission tomography; Psychosis; Reviews; depression; electrophysiology; functional magnetic resonance imaging; neuropharmacology; neuroimaging
• ISSN: 0334-1763; 2191-0200; 2191-0200
• DOI: 10.1515/revneuro-2019-0090

The drug ketamine has been extensively studied due to its use in anaesthesia, as a model of psychosis and, most recently, its antidepressant properties. Understanding the physiology of ketamine is complex due to its rich pharmacology with multiple potential sites at clinically relevant doses. In this review of the neurophysiology of ketamine, we focus on the acute effects of ketamine in the resting brain. We ascend through spatial scales starting with a complete review of the pharmacology of ketamine and then cover its effects on and electrophysiology. We then summarise and critically evaluate studies using EEG/MEG and neuroimaging measures (MRI and PET), integrating across scales where possible. While a complicated and, at times, confusing picture of ketamine’s effects are revealed, we stress that much of this might be caused by use of different species, doses, and analytical methodologies and suggest strategies that future work could use to answer these problems.