Ketamine: An Update

A short update to his 2016 ketamine post. The new finding (Williams et al; an author is Christine Blasey Ford) is that the opioid-blocker naltrexone abolishes ketamine's antidepressant effect while leaving its NMDA-linked dissociation intact -- implying the antidepressant action runs through the OPIOID system, an awkward result amid the War on Opiates. Scott connects it to the ultra-low-dose-buprenorphine-for-suicidality precedent, notes the establishment's 'well, f@#k' response (and its pivot to psychiatrist-monitored clinics, possibly a power grab), weighs addiction risks against the heroin-as-'safe-opiate' history, and floats the genuinely arresting reframe that 'depression is related to the stuff that has the strongest effect on human happiness of any molecule class known.'

Quality 64 · Strong. A competent, clear research-update with a couple of sharp observations (the opioid-system reframe; the opiates<->happiness<->depression plausibility) and good judgment about the politics. Limited depth and originality -- it reports others' findings and leans on the original post for context. Strong-low.

Claude’s paradigm shift 50 · Moderate. Reports a field finding plus light synthesis; the opioid-mechanism reframe is the literature's, not Scott's. Moderate.

Real-world impact 2 · Minor. A within-discourse research update; no material-world effect. Within-blog influence.