The collective lie in ketamine therapy: a call to realign clinical practice with neurobiology
Frontiers in Psychiatry September 22, 2025 Charles Miller, Bárbara Lopes, Anna Mccurdy
Ketamine therapy is often wrongly linked to psychedelic culture, but its therapeutic effect comes from blocking NMDA receptors to promote neuroplasticity, not from the acute dissociative experience. The dissociative state emphasized in ketamine-assisted psychotherapy is neither necessary nor sufficient for lasting improvement; meaningful recovery depends on plasticity-driven brain reorganization in the days after administration. Prioritizing subjective experience during dissociation risks distorting memory and reinforcing maladaptive narratives, undermining the potential of psychoplastogenic treatments. The article calls for evidence-based protocols aligned with neurophysiology, advocating for greater education, standardization, and scientific rigor in clinical practice.