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The rate of transport increases nearly linearly up to a serum ketone concentration of 10 mM, accompanied by a contemporaneous reduction in cerebral glucose utilization, supporting the rapid use of ketones as energy substrates when they are available [35,36,37]

Ketamine, a noncompetitive antagonist of the NMDAR, has been shown to induce rapid and significant antidepressant effects within a few hours

That overlap is part of why this combination gets discussed so often here

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Moreover, BTX-A can reduce the release of other neurotransmitters and neuromediators including epinephrine and norepinephrine