I’d rather you trust this than be dazzled by it. Here are some of the key studies behind the questions people ask me most, with what each one can and can’t tell us.
55% of people responded to ketamine, compared with 41% who responded to electroconvulsive therapy. Ketamine also avoided the memory problems linked to ECT.
The limits: the trial used IV ketamine without therapy, and most participants were outpatients. A Swedish trial of hospitalized patients found ECT did better.
In a trial of 73 people whose depression hadn’t improved with standard treatments, 64% responded within 24 hours of a single ketamine infusion, compared with 28% on an active placebo. Most antidepressants take weeks to start working.
The limits: IV ketamine, a single dose. Without further treatment, the difference between groups had faded by one week. That’s why my program uses repeated sessions and integration rather than one dose.
People with treatment-resistant depression took ketamine tablets for 12 weeks. At the highest dose, fewer relapsed (43% vs. 71% on placebo), with minimal dissociation and no blood-pressure changes.
The limits: only people who responded in the first week went on to the randomized part, and the tablets were an extended-release form, not a lozenge.
After a standard course of ketamine infusions for depression, the median time to relapse was about 18 days. A 2023 review of ketamine paired with psychotherapy found the combination “offers promise” for making benefits last longer.
The limits: the studies varied too much for firm conclusions, and only one small trial has compared ketamine with and without therapy directly.
People with severely treatment-resistant depression received ketamine within a structured therapy program. Their large drops in depression and anxiety were still there a month after their last dose, longer than typical ketamine-alone results.
The limits: 32 people, and the trial compared music with no music rather than therapy with no therapy.
Participants had lived with PTSD for a median of 14 years. 67% responded to ketamine, compared with 20% on an active placebo, and the trial was stopped early because ketamine’s lead was so clear.
The limits: a small trial of 30 people, with IV ketamine and no therapy. For those who responded, benefits lasted about four weeks on average.
This is one of the clearest examples of ketamine and therapy working together. People who received ketamine were more likely to stay sober than those who received a placebo, and the group who got ketamine alongside therapy did best of all.
The limits: 96 people, IV ketamine. The advantage of therapy over a simpler education program didn’t reach statistical significance.
Knowing what the research can and can’t promise helps you make a decision you’ll feel good about.
Further reading: Ketamine for OCD (Rodriguez, 2013) · Bipolar depression (Zarate, 2012) · Suicidal thoughts (Wilkinson, 2018) · KAP in clinical practice (Dore, 2019) · Real-world KAP outcomes (Yermus, 2024)
A free 15-minute call. Bring your questions about the research, too.
