Intravenous ketamine therapy produced a rapid improvement in depression severity among 14 patients with treatment-resistant depression, with significant effects observed one hour and two weeks after the final dose. However, this improvement was not significantly sustained at one month. Patients initially expressed safety concerns, comparing the treatment to general anesthesia, but most became advocates for ketamine therapy after experiencing rapid, transformative effects on severe depressive symptoms. The study used a mixed-methods approach, combining a quasi-experimental design with qualitative interviews.
Psychedelics like psilocybin, LSD, DMT/ayahuasca, MDMA, peyote, and ketamine alter perception, mood, and consciousness, and have been used for centuries in religious ceremonies. After clinical use of LSD from the 1950s until its ban in 1967, interest has resurged for treating PTSD, anxiety, depression, and substance use disorders. The FDA has designated several as breakthrough therapies. They work through mechanisms such as 5HT2A receptor agonism and NMDA antagonism, promoting neuroplasticity and disrupting pathological activity in the brain's default mode network to facilitate new perspectives and emotional processing. Psychedelic-assisted therapy includes preparation, dosing support, and integration. Safety concerns include hallucinogen persisting perception disorder, serotonin toxicity, and boundary violations. Comprehensive research is still needed.