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 Retrospective Effectiveness Study.
Ryan Yermus, John Bottos, Nathan Bryson, Joseph A. de Leo, Mitch Earleywine, Emily Hackenburg, Sidney H. Kennedy, Martha Kezemidis, Sarah Kratina, Robert McMaster, Ben Medrano, Monica Mina, Dominique Morisano, Michael Muench, Sabina Pillai, Randall Scharlach, Varun Setlur, Michael Verbora, Elizabeth Wolfson, Nabid Zaer, Chris Lo
Psychedelic Medicine June 1, 2024 DOI: 10.1089/psymed.2023.0021 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective effectiveness study Peer reviewed |
|---|---|
| Sample size | 346 |
| Population | Adults with a history of major depressive disorder, generalized anxiety disorder, or PTSD who had not responded to prior treatment interventions |
| Intervention | Ketamine-assisted psychotherapy |
| Duration | 6-month follow-up |
| Topics | Anxiety Depression Ketamine Psychedelic-assisted therapy PTSD Esketamine |
| Keywords | Ketamine-assisted psychotherapy PTSD Therapy Mental health treatment |
| Citations | 13 |
| Key points | KAP produced sustained reductions in anxiety, depression, and PTSD symptoms, with large treatment effects at 3 months (d = 0.75-0.86) and 6 months (d = 0.61-0.73), though high attrition limits validity. |
Abstract
Ketamine-assisted psychotherapy (KAP) is an emerging treatment option to alleviate treatment-resistant affective disorders, but its long-term effectiveness remains unclear. To examine the treatment effects of KAP on anxiety, depression, and post-traumatic stress disorder (PTSD) at 1, 3, and 6 months post-treatment. This retrospective effectiveness study included self-reported outcomes from adults with a history of major depressive disorder, generalized anxiety disorder (GAD), or PTSD who had not responded to prior treatment interventions and received KAP administered across 11 Field Trip Health clinics in North America between March 13, 2020, and June 16, 2022. The evaluable sample sizes were 346 and 94 participants at 3 and 6 months, respectively, representing loss to follow-up rates of 82% and 95%. KAP consists of 4-6 guided ketamine sessions (administered through intramuscular injection or sublingual lozenge) with psychotherapy-only integration visits after doses 1 and 2 and then after every 2 subsequent doses. Mean number of doses administered was 4, standard deviation (SD) = 3, and mean number of integration sessions was 3, SD = 2. Primary outcomes were changes in symptoms of depression, anxiety, and PTSD at 3 months relative to baseline, assessed, respectively, using the 9-item Patient Health Questionnaire, the 7-item GAD measure, and the 6-item PTSD checklist. Secondary outcomes were changes at 1 and 6 months relative to baseline. Large treatment effects were detected at 3 months (d's = 0.75-0.86) and were sustained at 6 months (d's = 0.61-0.73). Case reductions (identified based on cutoff values) ranged from 39% to 41% at 3 months and 29% to 37% at 6 months. In total, 50-75% reported a minimal clinically important difference at 3 months and 48-70% at 6 months. KAP produced sustained reductions in anxiety, depression, and PTSD, with symptom improvement lasting well beyond the duration of dosing and integration sessions. These effects extended to as much as 5 months after the last KAP session. However, the high rates of attrition may limit validity of the results. Given the growing mental health care crises and the need for effective therapies and models of care, especially for intractable psychiatric mood-related disorders, these data support the use of KAP as a viable alternative. Further prospective clinical research should be undertaken to provide evidence on the safety and effectiveness of ketamine within a psychotherapeutic context.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
-
KAP produced large treatment effects on depression, anxiety, and PTSD symptoms at 3 months (d = 0.75-0.86) and 6 months (d = 0.61-0.73), though attrition was very high.
Synthesized
Comparable studies
Other observational and cohort studies on ketamine and psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 12
- Novel psychedelic interventions for post-traumatic stress disorder and their promise for precision medicine. Therapeutic Advances in Psychopharmacology December 4, 2025
- Prophylactic Ketamine: Current Knowledge and Future Directions. Biological Psychiatry March 28, 2025
- Ketamine-assisted group psychotherapy integrating cognitive processing therapy to address identity-based trauma: a pilot study Frontiers in Psychiatry January 22, 2026
- Ketamine-Assisted Group Therapy for Work-Related Stress in First Responders and Frontline Health Care Workers Psychedelic Medicine April 21, 2025
- Monitoring of Clinics That Use Direct-to-Consumer Advertising for Off-Label Ketamine in the New York Metropolitan Area: A Cross-Sectional Systematic Web Search. Fundamental and Clinical Pharmacology July 1, 2026
and 7 more in the library
Cites 7
- A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders JAMA Psychiatry March 1, 2017
- The Experimental Use of Psychedelic (LSD) Psychotherapy JAMA June 15, 1970
- Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy Journal of Psychoactive Drugs March 15, 2019
- Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review BJPsych Open December 23, 2021
- The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Recommendations for the Use of Racemic Ketamine in Adults with Major Depressive Disorder: Recommandations Du Groupe De Travail Du Réseau Canadien Pour Les Traitements De L’humeur Et De L’anxiété (Canmat) Concernant L’utilisation De La Kétamine Racémique Chez Les Adultes Souffrant De Trouble Dépressif Majeur The Canadian Journal of Psychiatry November 11, 2020
and 2 more in the library