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. 2019 Dec 23;12:3413–3421. doi: 10.2147/JPR.S217005

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© 2019 Stoker et al.

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Hypothetical model explaining relationship of glutamate/NMDA activity in relevant CNS pathways with psychiatric symptoms. In this model, high glutamate/NMDA activity is associated with depression and low glutamate/NMDA activity is associated with psychosis. Ketamine reduces glutamate/NMDA activity in a dose-dependent manner. Depressed patients may have higher baseline glutamate/NMDA activity such that when given ketamine, they do not drop below the theoretical threshold necessary for the development of psychotic symptoms.