Ketamine: Benefits, risks, and promising therapeutic potential | Celia Morgan, Ph.D.

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
My guest this week is Celia Morgan. Celia is a Professor of Psychopharmacology at the University of Exeter in the UK. Celia's research focuses on the benefits and side effects of recreational drugs and alcohol on cognition, behavioral and neurobiology. And she's authored numerous publications on the potential use of ketamine and other drugs as therapies in mental health. She created her undergraduate degree and PhD at University College London, followed by a scholarship program that brought her to the United States where she studied at Yale. She conducted research at the University of Melbourne prior to returning to University College London, and eventually moving to the University of Exeter where she became the Chair of Psychopharmacology in 2015 In this episode, we dig deep into ketamine. We talk about the neurobiology and the chemistry of ketamine, how it affects individuals, how it affects specific parts of the brains, and how it differs from other things that we might think of as psychedelics, though I don't really consider ketamine to be a psychedelic, but we certainly contrast it with things like psilocybin and LSD. We then talk about its use case and the potential promise of ketamine, specifically around drug-resistant or recalcitrant, depression and alcoholism. We talk about the importance of therapy being offered concurrently with ketamine treatment, as many people listening to this might wonder if ketamine therapy is indeed for them. So without further delay, please enjoy my conversation with Celia Morgan.
Hey Celia, thanks for making time on a Friday evening to sit down and talk about ketamine and perhaps a few other things, but great to meet you.

**Celia Morgan** (2:20)
You too, thanks. It's my pleasure.

**Peter Attia** (2:22)
So let's talk a little bit about your background. I think you finished your graduate training in the UK, but then you did a stint here in the US at Yale, if I'm not mistaken, correct?

**Celia Morgan** (2:30)
So I did my undergraduate in psychology with pharmacology and astrophysics for a bit. And I did a PhD program at University College London.
But as part of that, I spent some time at Yale and I'd got a scholarship to do a little bit of research out there in the US.

**Peter Attia** (2:48)
So what did you focus on during your PhD?

**Celia Morgan** (2:50)
So my PhD was largely focused on the effects of ketamine.
We were looking both at the acute effects of ketamine as a model of psychosis. So at the time people were using ketamine with the idea that would help us understand the neurobiological underpinnings of psychosis, because actually from the outside, ketamine looks a little bit similar to people who are psychotic. And so we were using that to map the kind of cognitive processes altered by ketamine. But I was also simultaneously looking at people who take ketamine recreationally, because at the time that was quite a big problem in the UK. And when I went to the US, it was to work on again, some neuroimaging studies, looking at ketamine as a model for psychosis. So it was before it really became established as an antidepressant.

**Peter Attia** (3:38)
Let's talk a little bit about the history of ketamine. It was synthesized in the sixties, I believe.

**Celia Morgan** (3:43)
It was synthesized as an anesthetic. Synthesized as a replacement for PCP, or fencyclidine, because obviously people know PCP as angel dust, and there's this kind of folklore around it of people running at the police and being shot down and keeping running. But I mean, really the problems with it, had this protracted psychosis-like effects that lasted for a really long time following anesthesia. It was still a good analgesic anesthetic. They synthesized ketamine as a similar molecule.
So it still worked on the same receptor in the brain, the NMDA receptor, but it was 10 times less potent.
Yeah, so it was synthesized back in the 60s. And the drug company that synthesized it were initially really impressed by its analgesic and anesthetic effects. But then with increasing clinical experience, it was noticed that people were coming around from ketamine anesthesia reporting a variety of quite weird effects. So things like hallucinations and out of body experiences. And that's what's really limited its routine clinical use, but it's still one of the most widely used anesthetics in the world today. It's on the World Health Organization list of essential medicines.