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Ketamine-Assisted Psychotherapy for Treatment- Resistant Depression with Comorbid Post-Traumatic Stress Disorder in Veterans

O. Orlov Aleksey, V. Zaika, O. Fitkalo

Insight the psychological dimensions of society November 19, 2025 DOI: 10.32999/2663-970x/2025-14-6 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Open-label naturalistic study Peer reviewed
Sample size 27
Population Ukrainian veterans with treatment-resistant depression and PTSD symptoms
Intervention Ketamine-assisted psychotherapy
Dose 0.5-1.0 mg/kg of body weight
Duration 1-4 infusions, with assessments before treatment, after treatment, and one month after treatment
Topics Depression Esketamine Ketamine Psychedelic-assisted therapy PTSD
Keywords Depression economics Stress linguistics Comorbidity Psychotherapist
Key points Ketamine-assisted psychotherapy significantly reduced depression and PTSD symptoms in veterans, with benefits sustained for at least one month.

Abstract

The aim of the study was to evaluate the practice of using ketamine-assisted psychotherapy (KAT) in accordance with international clinical guidelines at the State Institution "Center for Mental Health and Veterans' Rehabilitation 'Lisova Polyana' of the Ministry of Health of Ukraine" (Ukraine).Adapting the international clinical guidelines on ketamine therapy for treatmentresistant depression within the Ukrainian medical system in the context of war was the main focus of the study.Methods.The study had an openlabel, non-blinded naturalistic design with a single group of participants (n = 27).The sample included veterans with confirmed treatmentresistant depression (TRD) and PTSD symptoms.The KAT course consisted of 1-4 ketamine infusions at doses of 0.5-1.0mg/kg of body weight, accompanied by preparatory and integration psychotherapy sessions.Symptom dynamics were assessed using the "PHQ-9" (Kroenke et al., 2001), "BDI" (Beck et al., 1996), and "PCL-M" (Weathers et al., 1993) questionnaires.Psychodiagnostics were performed before treatment, after treatment, and one month after treatment.Nonparametric statistical methods (Wilcoxon signed-rank test, Spearman's correlation coefficient, Hedges' g) and correlational analysis were applied to explore relationships between outcomes and other variables.Results.The majority of participants demonstrated a significant reduction in depression symptoms (PHQ-9: p < .001,g = 1.31;BDI: p < .001,g = 1.20) and PTSD symptoms (PCL-M: p < .001,g = 1.10).More than 50.00% of participants achieved either substantial clinical improvement or remission.In 22.00-26.00% of participants, symptoms remained unchanged or slightly worsened, underscoring the need for an individualized treatment approach.The positive therapeutic effect persisted for at least one month after completion of treatment.While no correlation was found between KAT outcomes and participants' age or the therapist's personality,

Comparable studies

Other non-randomized and open-label trials on ketamine and psychedelic-assisted therapy, most cited first.

Study Year Design Participants
Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research Alcoholic patients 1997 Controlled clinical trial n = 211
Ketamine-assisted psychotherapy provides lasting and effective results in the treatment of depression, anxiety and post traumatic stress disorder at 3 and 6 months: Findings from a large single-arm retrospective effectiveness trial Adults with a history of depression, anxiety, or PTSD who had not responded to prior... 2023 Retrospective single-arm effectiveness trial n = 1,806
Protocol of an open-label safety and feasibility pilot study of ketamine-assisted psychotherapy for methamphetamine use disorder (the KAPPA trial). Adults meeting DSM-5-TR criteria for methamphetamine use disorder seeking to reduce or... 2025 Open-label, single-arm clinical trial n = 20
Exploratory non-randomized clinical trial of subcutaneous esketamine in treatment-resistant depression: Effects of ketamine-assisted psychotherapy Patients with treatment-resistant depression 2026 Nonrandomized, open-label clinical trial n = 46
Navigating ‘k-land’: a qualitative exploration of participants’ experiences of ketamine-assisted psychotherapy for methamphetamine use disorder Participants with methamphetamine use disorder who completed core components of... 2026 Qualitative study embedded within an open-label pilot trial n = 14

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