Ketamine, the First Associative Anesthetic? Some Considerations on Classifying Psychedelics, Entactogens, and Dissociatives

Ketamine is proposed to fit better within a broader psychopharmacology framework that links dissociatives, classical psychedelics, and entactogens through shared experiential and systems-level effects rather than strict receptor-based labels. The discussion draws on work showing ketamine can produce prosocial and empathy-related changes, including depression-related improvements that emphasize reduced pleasure tied to social situations, plus an animal behavioral paradigm in which ketamine shifts “observer” rats away from lever pressing when it would harm a “demonstrator” rat. The authors argue that receptor-driven classification (for example NMDA, 5-HT2A, or monoamine transporter targets) may miss what matters for clinical potential because ketamine’s phenomenology and rapid, durable psychiatric effects overlap with those of LSD and psilocybin, and conceptually align with entactogens exemplified by MDMA. They call for multidimensional, network-focused taxonomies that can adapt as mechanistic evidence evolves.