For decades, depression was blamed on a chemical deficit, but what if brain imaging has been taking snapshots at the wrong times? A landmark systematic review reveals that ketamine leaves 24-hour resting neurotransmitter levels unchanged—because its true antidepressant power is a dynamic balancing act unfolding mid-infusion. Discover how acute glutamate cycling disrupts rigid neural ruts to reset the excitation-inhibition balance, and why baseline Glx/GABA ratios in the anterior cingulate cortex predict clinical remission. We unpack how these real-time neurochemical shifts validate the patient experience and open doors for precision psychiatry. Tune in to explore why ketamine tunes the brain rather than applying a blunt chemical fix.
Resources: Singh, B., Ali, H. M., Miola, A., Nunez, N. A., Fogaça, M. V., Jelen, L. A., Prokop, L. J., Sanacora, G., Zarate, C. A., Jr., Frye, M. A., & Port, J. D. (2026). Modulation of GABA and glutamate by ketamine in depression: A systematic review and meta-analysis of magnetic resonance spectroscopy studies. *Neuropsychopharmacology*. Advance online publication. https://doi.org/10.1038/s41386-026-02562-4
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