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Reopening Critical Periods: The Mechanism Behind Ketamine’s Healing Potential

Psychedelics, including substances like LSD, MDMA, psilocybin, ibogaine, and ketamine, elicit profound shifts in sensory perception, self-awareness, and time-space perception. These experiences are so fundamentally different from our everyday consciousness that they can offer valuable insights into the inner-workings of the human mind.

While the mechanism of action of certain psychedelics, such as ketamine, is well-understood and studied, there exists a less explored, and relatively novel concept, referred to as 'critical periods.' These critical periods within the brain become more accessible after psychedelic therapy, and offer an opportunity for the external environment to exert broader influence over brain development, learning, and the establishment of new habits and behaviors.

Published in the journal Nature in June,  Gül Dölen, M.D., Ph.D., associate professor of neuroscience at the Johns Hopkins University School of Medicine, explains how psychedelic drugs work to treat conditions such as depression, addiction and post-traumatic stress disorder (PTSD).  Dr. Dölen states,

"There is a specific window of time during which the mammalian brain is highly receptive and responsive to learning from its environment. This window eventually closes, making the brain less receptive to new learning."

Today, we will explore the concept of critical periods in greater depth, examine how it applies to ketamine therapy, and offer recommendations on how to harness the therapeutic potential of ketamine therapy by understanding and utilizing these critical periods for healing.

Reopening Critical Periods

During the developmental stages, the brain becomes highly sensitive to stimuli, rendering it more flexible in adapting to behavioral changes. These critical periods have long intrigued neuroscientists, who have sought ways to harness this power for therapeutic purposes. Researchers investigating the effects of substances like psilocybin, MDMA, LSD, ketamine, and ibogaine, have found that these substances reopen the critical period for social reward learning. This suggests a shared mechanism among psychedelics, challenging the notion that their subjective properties alone define their therapeutic potential. This discovery aligns with the therapeutic effects of psychedelic-assisted psychotherapy for conditions like depression, anxiety, PTSD, and addiction.

The concept of a critical period bears resemblance to the experience of teaching a puppy a new trick. It often appears significantly easier to instruct a young dog to sit or shake, as they are more eager to please and receptive to learning. In contrast, attempting to teach an older dog something new can be challenging, as they become set in their ways and less inclined to disrupt their established routines. Likewise, acquiring a new language is notably more manageable during one's early years, when the mind seems more adaptable and open to embracing novel concepts. Ketamine and other psychedelics seem to induce a state in the mind that resembles a youthful receptivity, making learning and behavioral changes more accessible and achievable.

Duration of the Critical Period

Research has unveiled a correlation between the duration of a critical period reopening triggered by psychedelics and the length of their acute effects. Ketamine has exhibited lasting antidepressant effects, but its shorter duration of action initiates a reopening of a critical period that lasts for forty-eight hours. Compounds like LSD and ibogaine, which induce longer-lasting subjective effects, seem to extend the reopening of the critical period for weeks. This discovery underscores the great significance of post-treatment psychotherapy and integration in clinical psychedelic therapy, particularly in the context of ketamine therapy, shortly after the administration of the drug.

Taking Action and Integration: Maximizing the Benefits During Critical Periods

Dr. Dolen states, “The open state of the critical period may be an opportunity for a post-treatment integration period to maintain the learning state.” At Innerbloom, integration entails psychotherapy sessions interspaced in between infusions designed to incorporate insights or newly acquired self-knowledge into the ongoing healing process. Dr. Dölen suggests,

“Too often, after having a procedure or treatment, people go back to their chaotic, busy lives that can be overwhelming. Clinicians may want to consider the time period after a psychedelic drug dose as a time to heal and learn, much like we do for open heart surgery.”

So, what can we glean from the concept of critical periods and how does it relate to someone undergoing ketamine therapy? Having personally witnessed the profound and rapidly acting effects of ketamine, I have observed an interesting trend that corresponds with this concept of a window of opportunity during which individuals have the potential to make changes that will have lasting effects. Those who actively make changes, such as incorporating healthy lifestyle changes (like starting a new exercise routine, practicing meditation, or improving their sleep habits) or change unhealthy habits such as excessive alcohol intake, tend to experience better outcomes compared to those who make no lifestyle changes during the process.


Psychedelics have exhibited significant promise in the treatment of various neuropsychiatric conditions, but their multiple mechanisms remain the subject of intensive investigation. This research suggests that psychedelics may share a mechanism involving the reopening of critical periods, possibly related to their unique altered states of consciousness. The duration of a critical period reopening varies among different psychedelics. Nevertheless, it appears that there is a specific window of opportunity after a psychedelic experience during which it is appropriate, and important to integrate the experience and implement lifestyle and self-care changes to harness the maximum therapeutic potential.

In the future, further studies may explore the potential application of psychedelics for unlocking critical periods in the context of a range of neurological and psychological disorders. However, for the time being, it is important to note that there are multiple mechanisms that may explain why patients experience significant symptom relief and seemingly accelerated healing with medicines such as ketamine.

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