CASAC Client, Family and Community Education Practice Test

Ketamine can produce dissociative and psychotomimetic effects, meaning it can create experiences that feel detached from reality and can include paranoid thinking. Paranoid thoughts are a recognizable feature of adverse ketamine reactions because the drug disrupts normal brain signaling (via NMDA receptor antagonism), leading to distorted perceptions, misinterpretations of others’ intentions, and fear-driven ideas.

This makes paranoid thoughts the best match among the options because it directly reflects a paranoid ideation component. The other possibilities describe broader or different phenomena: trouble expressing thoughts points to speech or thought-flow issues; altered consciousness is a general change in awareness; and enhanced sexual pleasure is not a typical adverse ketamine effect.