Ketamine blocks the calcium channel associated with N-methyl-D-aspartate (NMDA) glutamate receptors. It has transient behavioral effects in healthy humans that resemble aspects of schizophrenia, dissociative disorders, and ethanol intoxication. Ethanol is an antagonist of both NMDA receptors and L-type voltage-sensitive calcium channels (VSCC) and it has minimal psychotogenic activity in humans. A double-blind placebo-controlled study was conducted that evaluated whether pretreatment with the L-type VSCC antagonist, nimodipine, 90 mg D, modulated ketamine response (bolus 0.26 mg/kg, infusion of 0.65 mg/ kg/hr) (Krystal et al. 1999c). In addition, these drugs produce effects in healthy human subjects that resemble aspects of the signs and symptoms of schizophrenia or dissociative disorders (Krystal et al. 25 , NO . 6 Nimodipine-Ketamine Interactions 937 1999a). As a result, ketamine administration may provide a laboratory-based approach that may contribute to the characterization of NMDA receptor contributions to cognitive function and the development of novel pharmacotherapeutic approaches that might ameliorate the consequences of NMDA receptor dysfunction. NMDA receptor antagonists also have ethanol-like behavioral effects in animals and humans (Grant and Colombo 1993;Krystal et al. 1998b;Petrakis et al. 2001). In ethanol dependent patients, ketamine effects were deemed more similar to ethanol effects than they were to the effects of marijuana or cocaine (Krystal et al. 1998b). This observation is consistent with studies indicating that NMDA receptors are among the highest affinity targets of ethanol in the brain, where it produces dose-related uncompetitive antagonism of receptor function (Grant and Lovinger 1995;Lovinger 1997). In animals, the behavioral effects of ethanol have a complex neurobiology, reflecting the interaction of the many component dose-related actions of ethanol in the brain (Green and Grant 1998).Ethanol, relative to the uncompetitive NMDA receptor antagonists phencyclidine and ketamine, has less propensity to produce psychotic symptoms in healthy humans or recovering ethanol-dependent patients (Krystal et al. 1994a;Krystal et al. 1998b;Luby et al. 1959). The limited psychotogenic propensity of ethanol at doses typically associated with human intoxication may reflect the capacity of ethanol facilitation of GABA A receptor function to moderate its NMDA antagonist effects (Grant and Lovinger 1995). Consistent with this hypothesis, some reduction in the perceptual effects of ketamine in healthy human subjects was produced by lorazepam pretreatment (Krystal et al. 1998a). However, preclinical data suggest that the capacity of ethanol to block L-type VSCCs (Crews et al. 1996) may also protect against its psychotogenic potential. In animals, components of the behavioral and discriminative stimulus effects of NMDA antagonists are attenuated by pretreatment with L-type VSCC antagonists (Green and Grant 1999;Green-Jordan and Grant 2000;Popoli et al. 1992;Sukhotina et al. 1999).The current ...