Response to commentaries on "The ketamine model of the near-death experience ..."

The author responds to commentators on their earlier paper about ketamine and near-death experiences (NDEs). Set and setting influence both drug effects and NDEs. Some NDEs are anxiety-generating, like some ketamine experiences, but frightening NDEs are often ignored by researchers. High-frequency compulsive ketamine use is rare. Dimethyltryptamine (DMT) can induce NDEs but this is not typical, whereas NDE-like effects are typical of ketamine. The speed of drug onset does not relate to its capacity to induce NDEs. The existence of endopsychosins is doubtful, but NMDA receptor blocking mechanisms are real. NDEs and dream sleep may involve similar mechanisms. Altered states do not require a normally functioning brain. The author discusses the possible evolutionary advantage of the NDE mechanism.

Study at a glance

Abstract

The commentators on my paper raised several interesting is sues. Set and setting do influence drug effects, but they also influence near death experiences (NDEs). Some NDEs are very anxiety-generating, just like some ketamine experiences, though frightening NDEs have been ignored by most researchers. High frequency, compulsive ketamine use is rare. While dimethyltryptamine (DMT) may induce NDEs, this is far from typical, while NDE-like effects are typical of ketamine. Rapidity of onset is not related to the capacity of a drug to induce NDEs. The reality of endopsychosins is doubtful, but the reality of N-methyl-D-aspartate (NMDA) blocking mecha nisms is not. NDEs and dream sleep may involve similar mechanisms. Al tered states of consciousness do not require a normally functioning brain. Finally, I discuss the possible evolutionary advantage of the NDE mecha nism.