This discussion uncovers the complex relationship between ketamine use and its neurotoxic potential. Key points include: - The disparity between therapeutic and recreational doses, with recreational users often consuming excessively high amounts, raising concerns about potential neurotoxicity. - Some commenters relate their experiences with tolerance and fears of long-term cognitive effects from other medications, suggesting a broader impact of these substances on brain function. - There's mention of ketamine’s role as an NMDA receptor agonist and its positive influence on neuroplasticity, which contradicts the idea of it being neurotoxic at prescribed levels, although high doses could pose risks. Overall, while therapeutic use may enhance brain function, excessive recreational use raises significant concerns regarding safety and long-term cognitive health.