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Ketamine and psychedelic-assisted therapy

Studies whose primary subject is both Ketamine and Psychedelic-assisted therapy, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 25 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for Ketamine, racemic ketamine, arketamine, R-ketamine, Psychedelic-assisted therapy, psychedelic therapy, then ranked by relevance.

Across the research, ketamine-assisted psychotherapy (KAP) is consistently associated with reduced depression, anxiety, PTSD, and substance-craving symptoms, with several controlled trials in addiction showing large abstinence advantages over comparison conditions (e.g., roughly 66% vs 24% one-year abstinence in alcoholism; higher abstinence with repeated vs single sessions). Effects appear to depend partly on the psychedelic/subjective experience and on psychotherapy dose, and some trials show benefit fading or disappearing at longer follow-up. The main caveats are small samples, high attrition, mostly open-label or observational designs, and limited durability data.

Evidence by study

Direction is which way each study's own result points, not our rating of the study.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
Ketamine Psychedelic Therapy (KPT): A Review of the Results of Ten Years of Research 1997 controlled clinical trial 211 Supports Adding ketamine psychedelic therapy to standard alcoholism treatment produced 65.8% one-year abstinence versus 24% with conventional treatment alone (p < 0.01).
Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. 2002 RCT 70 Supports High-dose (2.0 mg/kg) ketamine psychotherapy produced significantly greater two-year abstinence, greater and longer-lasting craving reduction, and greater positive change in unconscious emotional attitudes than low-dose (0.2 mg/kg) ketamine psychotherapy.
Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy 2019 observational study 235 Supports Ketamine-assisted psychotherapy appeared effective for decreasing depression and anxiety, especially in older patients and those with severe symptom burden.
Single Versus Repeated Sessions of Ketamine-Assisted Psychotherapy for People with Heroin Dependence 2007 RCT 59 Supports Three ketamine-assisted psychotherapy sessions yielded significantly higher one-year abstinence (50%) than a single session (22.2%), with no group differences in depression, anxiety, craving, or meaning in life.
The need for establishing best practices and gold standards in psychedelic medicine. 2023 review Unclear Argues that the medical community should help develop standards of care and gold standards for psychedelic-assisted therapy based on data quantity and quality, trial rigor, and comparative safety and efficacy.
A Cohort-Based Case Report: The Impact of Ketamine-Assisted Therapy Embedded in a Community of Practice Framework for Healthcare Providers With PTSD and Depression 2022 quality improvement evaluation with mixed methods 94 Supports A ketamine-assisted psychotherapy program delivered in a community-of-practice group model led to clinically significant improvements in depression, PTSD, generalized anxiety, and work/life functionality.
Expert Opinion on Psychedelic-Assisted Psychotherapy for People with Psychopathological Psychotic Experiences and Psychotic Disorders 2024 qualitative study 12 Supports Experts agreed that psychedelic-, ketamine-, and MDMA-assisted psychotherapy with high levels of support are not necessarily contraindicated for all individuals with psychotic conditions and may benefit some.
Ketamine-assisted psychotherapy in adolescents with multiple psychiatric diagnoses. 2023 case series 4 Supports Ketamine-assisted psychotherapy was associated with symptomatic and functional improvements and was well-tolerated in four adolescents with complex, treatment-resistant disorders.
Phenomenology and therapeutic potential of patient experiences during oral esketamine treatment for treatment-resistant depression: an interpretative phenomenological study. 2023 qualitative study 17 Mixed Esketamine experiences were highly variable and psychological distress was common, but some effects such as increased openness and detachment were reported as having psychotherapeutic potential.
A comparison between psilocybin and esketamine in treatment-resistant depression using number needed to treat (NNT): A systematic review. 2024 systematic review Supports Both 25 mg psilocybin and fixed-dose esketamine (56 mg and 84 mg) showed clinically meaningful number-needed-to-treat estimates with acceptable harm profiles in treatment-resistant depression.
Ketamine-assisted psychotherapy, psychedelic methodologies, and the impregnable value of the subjective—a new and evolving approach 2024 theoretical Supports Argues that ketamine's dissociative and altered-state effects at subanesthetic doses are intrinsic to its therapeutic impact rather than mere side effects, especially within a supportive therapeutic setting.
Meta-correlation of the effect of ketamine and psilocybin induced subjective effects on therapeutic outcome. 2024 systematic review and meta-analysis 654 Supports Subjective effects of ketamine and psilocybin modestly mediated therapeutic outcomes (R2 5-10% for ketamine; 24% for psilocybin), with a stronger mediating effect for psilocybin, particularly in depression.
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. 2024 retrospective effectiveness study 346 Supports Ketamine-assisted psychotherapy produced large treatment effects on depression, anxiety, and PTSD at 3 months (d = 0.75-0.86) and 6 months (d = 0.61-0.73), though attrition was very high.
The Efficacy of Psychedelic-Assisted Therapy in Managing Post-traumatic Stress Disorder (PTSD): A New Frontier? 2022 review Unclear Reviews evidence on MDMA, ketamine, classical psychedelics, and cannabis for PTSD and concludes psychedelic-assisted therapy shows potential but more research is needed to establish efficacy.
Ketamine and Ketamine-Assisted Psychotherapy for Psychiatric and Existential Distress in Patients with Serious Medical Illness: A Narrative Review. 2025 systematic review Supports Nine studies and 12 case reports reported positive results and good safety for ketamine or ketamine-assisted psychotherapy, but most evidence concerned ketamine as a pharmacologic agent and there was a large gap for existential distress.
A longitudinal analysis of the clinical practice of ketamine assisted psychotherapy with adolescents and young adults 2026 observational cohort 19 Supports Among 19 adolescents and young adults completing three or more ketamine-assisted psychotherapy sessions, depression scores declined by an estimated 0.65 points per visit and anxiety by 0.21 points per visit, with overall benefit reported in 68% of cases.
Making Play Safe Again: Ketamine-Assisted Psychotherapy with Traumatized Autistic Adults 2026 theoretical Supports Argues that ketamine-assisted psychotherapy can create a transitional space helping autistic adults reconnect with affective and embodied experience and transform trauma into integrated narratives.
Oncology Providers' Perspectives on Psychedelic-Assisted Therapy. 2026 cross-sectional survey 385 Opposes 80% of oncology providers did not feel comfortable counseling patients on psychedelic-assisted therapy and only 44% were familiar with its legal status, though willingness to recommend it was linked to familiarity with emerging data.
Ketamine assisted psychotherapy to reduce chronic neuropathic pain: A mixed-methods randomized pilot trial. 2026 mixed-methods randomized pilot trial Mixed Ketamine-assisted psychotherapy was feasible and acceptable for chronic neuropathic pain, with both groups experiencing reduced pain intensity and improved mood; qualitative findings suggested psychotherapy may add psychological benefits.
Exploratory non-randomized clinical trial of subcutaneous esketamine in treatment-resistant depression: Effects of ketamine-assisted psychotherapy 2026 nonrandomized open-label clinical trial 46 Supports Adding ketamine-assisted psychotherapy to subcutaneous esketamine produced lower MADRS scores at sessions seven and eight and higher remission at treatment completion (78.3% vs 34.8%), but no group differences persisted over six months of follow-up.
The Hidden Architecture of Psychedelic Therapy How Music Shapes Emotion, Imagery, Memory, Surrender, and Ketamine Tolerability A White Paper Based on 41 Studies of Music in Psychedelic- 2026 review Supports Across 41 studies, music appears as an active session-shaping variable in psychedelic and ketamine therapy, intensifying and organizing emotion, shaping imagery and memory, supporting surrender, and making ketamine treatment more tolerable.
Mystical Experiences as Catalysts in Ketamine-Assisted Psychotherapy: A Case Study 2026 case study 1 Supports In one patient undergoing four ketamine-assisted psychotherapy sessions, greater therapeutic gains followed sessions with higher mystical-experience scores, and the patient attributed improvement to the psychological and spiritual impact and the therapeutic relationship.
Dance of the four bodies: an enactive-individuative approach to ketamine assisted psychotherapy 2026 theoretical Unclear Argues that an expanded enactivist framework including a fourth individuative body better explains transformative psychedelic experiences than computationalist models, and that ketamine's effects involve distinct arrangements of these bodies influenced by dosage and set and setting.
Navigating ‘k-land’: a qualitative exploration of participants’ experiences of ketamine-assisted psychotherapy for methamphetamine use disorder 2026 qualitative study 14 Supports Participants experienced ketamine-assisted psychotherapy as a context-dependent process in which ketamine created temporary psychological space supporting psychotherapy engagement, while sustained behavioral change depended on ongoing therapeutic and contextual factors.
Ketamine-assisted psychotherapy for posttraumatic stress disorder: a systematic review and individual participant data meta-analysis of predictors of treatment effects. 2026 systematic review and individual participant data meta-analysis 533 Supports Greater PTSD symptom improvement after combined ketamine and psychotherapy was associated with more psychotherapy sessions, more ketamine sessions, higher baseline severity, and shorter treatment duration; nine of twelve included studies were of poor quality.

Points of agreement

  • Multiple controlled and observational studies report that ketamine-assisted psychotherapy reduces depression, anxiety, PTSD, and substance-craving symptoms.
  • The intensity of the psychedelic/subjective experience appears related to therapeutic outcome, with higher-dose or more mystical-type experiences linked to greater benefit in several studies.
  • Psychotherapy dose and integration appear to matter: more sessions and structured therapeutic context are associated with better outcomes.
  • Effects are generally described as rapid but not always durable, with some trials showing benefit fading or disappearing at longer follow-up.

Conflicts

  • Some trials show large, sustained abstinence advantages for ketamine-assisted psychotherapy in addiction, while others find no group differences on depression, anxiety, or craving.
  • One trial found no between-group differences persisting at six-month follow-up despite strong short-term remission advantages.
  • Subjective effects mediated outcomes only modestly for ketamine (R2 5-10%) in one meta-analysis, whereas other studies emphasize the psychedelic experience as central to therapeutic change.

Gaps

  • Durability of effects beyond six months is poorly established, with high attrition in longer follow-up studies.
  • Most evidence comes from small samples, open-label or observational designs, and few adequately blinded randomized trials.
  • Adolescent, older adult, autistic, and psychotic-spectrum populations are studied only in case series, qualitative work, or expert opinion.
  • Optimal dose, number of sessions, route of administration, and psychotherapy protocol are not standardized across studies.
  • Provider knowledge and comfort with psychedelic-assisted therapy remain low, and implementation and training needs are largely unstudied.
Browse these studies in the library

Common questions

What does the research agree on about ketamine and psychedelic-assisted therapy?
  • Multiple controlled and observational studies report that ketamine-assisted psychotherapy reduces depression, anxiety, PTSD, and substance-craving symptoms.
  • The intensity of the psychedelic/subjective experience appears related to therapeutic outcome, with higher-dose or more mystical-type experiences linked to greater benefit in several studies.
  • Psychotherapy dose and integration appear to matter: more sessions and structured therapeutic context are associated with better outcomes.
  • Effects are generally described as rapid but not always durable, with some trials showing benefit fading or disappearing at longer follow-up.
Where do studies on ketamine and psychedelic-assisted therapy conflict?
  • Some trials show large, sustained abstinence advantages for ketamine-assisted psychotherapy in addiction, while others find no group differences on depression, anxiety, or craving.
  • One trial found no between-group differences persisting at six-month follow-up despite strong short-term remission advantages.
  • Subjective effects mediated outcomes only modestly for ketamine (R2 5-10%) in one meta-analysis, whereas other studies emphasize the psychedelic experience as central to therapeutic change.
What is still unknown about ketamine and psychedelic-assisted therapy?
  • Durability of effects beyond six months is poorly established, with high attrition in longer follow-up studies.
  • Most evidence comes from small samples, open-label or observational designs, and few adequately blinded randomized trials.
  • Adolescent, older adult, autistic, and psychotic-spectrum populations are studied only in case series, qualitative work, or expert opinion.
  • Optimal dose, number of sessions, route of administration, and psychotherapy protocol are not standardized across studies.
  • Provider knowledge and comfort with psychedelic-assisted therapy remain low, and implementation and training needs are largely unstudied.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is Ketamine and psychedelic-assisted therapy, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when Ketamine and psychedelic-assisted therapy or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

87 articles · 45 from the last two years · 6,425 participants across 50 studies reporting sample size

Common study designs

review 16 case study 8 case report 5 narrative review 5 systematic review 8

Research volume by year

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83 studies whose primary subject is ketamine and psychedelic-assisted therapy since 2002

Studies about ketamine and psychedelic-assisted therapy per year, 2002 to 2026, peaking at 22 in 2025 Bar chart: one bar per year, taller where more studies were published that year. 0 15 30 2005 2010 2015 2020 2025
2026 is partial
Show the numbers
Studies about ketamine and psychedelic-assisted therapy per year, 2002 to 2026, peaking at 22 in 2025
Year Studies
2002 1
2003 0
2004 0
2005 0
2006 0
2007 1
2008 0
2009 0
2010 0
2011 0
2012 0
2013 0
2014 0
2015 0
2016 0
2017 0
2018 0
2019 2
2020 0
2021 4
2022 6
2023 10
2024 18
2025 22
2026 19

Research

Synthesize the evidence →

A longitudinal analysis of the clinical practice of ketamine assisted psychotherapy with adolescents and young adults

Frontiers in Psychiatry September 21, 2026 Phil Wolfson, Cody Carroll

Introduction Ketamine Assisted Psychotherapy (KAP) is a developing modality with broad impact on humans suffering with a variety of emotional and relationship difficulties that encompass many diagnostic entities. Our application of KAP has extended to and included the treatment of adolescents and young adults in a family therapy format. Given the increasing scope and complexity of the...

DOI: 10.3389/fpsyt.2026.1886833 (opens in new tab)

Making Play Safe Again: Ketamine-Assisted Psychotherapy with Traumatized Autistic Adults

Psychoanalytic Inquiry August 28, 2026 Diana Moga

Autistic individuals are more susceptible to trauma due to higher baseline anxiety and overwhelm; poorer episodic memory; and the frequent lack of a sense of community, safety, and belonging that are both protective and needed to heal from trauma. Furthermore, many autistic adults have adopted a false self to get by in a neurotypical world and are often cut off from their affective, embodied...

DOI: 10.1080/07351690.2026.2721958 (opens in new tab)

Oncology Providers' Perspectives on Psychedelic-Assisted Therapy.

The American journal of hospice & palliative care August 28, 2026 Krishna Hanubal, Akul Munjal, Jino Park et al.

PurposeDespite most psychedelic substances remaining Schedule I, clinical research exploring psychedelic-assisted therapy (PAT) in oncology is expanding. We sought to assess oncology providers' attitudes toward and understanding of PAT.MethodsWe conducted a cross-sectional survey of healthcare professionals involved in oncology across five academic institutions in California, South Carolina,...

DOI: 10.1177/10499091261483604 (opens in new tab) Full text (opens in new tab) MDMA Ketamine Psilocybin Antidepressants +4

Exploratory non-randomized clinical trial of subcutaneous esketamine in treatment-resistant depression: Effects of ketamine-assisted psychotherapy

Journal of Affective Disorders August 10, 2026 Yves Martins Varela, Patrícia Cavalcanti-Ribeiro, Geovan Menezes de Sousa et al.

BACKGROUND: Ketamine is an effective rapid-acting treatment for treatment-resistant depression (TRD), producing antidepressant effects within hours of administration. Because it induces states of heightened neuroplasticity and psychological openness, psychotherapy may enhance its therapeutic effects. METHODS: This exploratory, nonrandomized, open-label clinical trial evaluated the adjunctive...

DOI: 10.1016/j.jad.2026.122369 (opens in new tab)

The Hidden Architecture of Psychedelic Therapy How Music Shapes Emotion, Imagery, Memory, Surrender, and Ketamine Tolerability A White Paper Based on 41 Studies of Music in Psychedelic-

Zenodo (CERN European Organization for Nuclear Research) July 21, 2026 Michael Alvear

Music is often treated as an atmospheric accessory in psychedelic and ketamine therapy: useful, pleasant, optional, or merely calming. That framing is too weak. Across a curated evidence base of 41 studies, reviews, mechanistic papers, clinical reports, playlist-design papers, ketamine-specific studies, ceremonial-music papers, and counterarguments, music repeatedly appears as an active...

DOI: 10.5281/zenodo.21480416 (opens in new tab)

Mystical Experiences as Catalysts in Ketamine-Assisted Psychotherapy: A Case Study

Journal of Psychoactive Drugs July 3, 2026 Miguel Joaquim Soares Teles Couceiro, Victor José da Conceição Teixeira Amorim Rodrigues, Nuno Manuel Correia Torres

This case study explores the potential role of mystical-type experiences in ketamine-assisted psychotherapy (KAP). A patient with generalized anxiety disorder and migraines underwent four intramuscular KAP sessions (0.5-0.9 mg/kg). Outcomes were assessed using the Outcome Questionnaire-45 (OQ-45), the Hood Mysticism Scale (HMS), and interviews. Greater therapeutic gains followed sessions with...

DOI: 10.1080/02791072.2026.2696253 (opens in new tab) Mysticism Anxiety disorder Therapeutic relationship Outcome game theory +4

Dance of the four bodies: an enactive-individuative approach to ketamine assisted psychotherapy

Psychedelics July 1, 2026 Aragorn Eloff, Alessandro Gonçalves Campolina

In this paper, which is in part intended as a speculative provocation and which combines philosophy of science, clinical practice and psychedelic therapy in a novel manner, we examine ketamine-assisted psychotherapy (KAP) through the lens of an expanded model of enactive cognition. While much work within both KAP and psychedelic-assisted therapy (PAT) in general has relied upon broadly...

DOI: 10.1016/j.psyche.2026.100033 (opens in new tab) Philosophy of mind Experiential learning Transformative learning Enactivism +11

Navigating ‘k-land’: a qualitative exploration of participants’ experiences of ketamine-assisted psychotherapy for methamphetamine use disorder

Frontiers in Psychiatry June 24, 2026 Kathryn Fletcher, Nadine Ezard, Krista J. Siefried et al.

Background Methamphetamine use disorder (MAUD) is associated with substantial psychiatric and physical morbidity, and current treatment options remain limited. Ketamine-assisted psychotherapy (KAP) has shown promise in substance use disorders, but little is known about how individuals experience and interpret this intervention, particularly in MAUD. Qualitative investigation may provide insight...

DOI: 10.3389/fpsyt.2026.1873497 (opens in new tab) Thematic analysis Context archaeology Cognition Qualitative research +8

Ketamine-assisted psychotherapy for posttraumatic stress disorder: a systematic review and individual participant data meta-analysis of predictors of treatment effects.

Psychotherapy and Psychosomatics June 19, 2026 Judith Rohde, Tyler M Moore, Kathryn Walker et al.

Ketamine combined with psychotherapy has shown promise in treating posttraumatic stress disorder (PTSD), but predictors of clinical benefit remain unclear. In this systematic review and individual participant data meta-analysis (IPDMA), we examined patient- and treatment-level predictors of PTSD symptom change after combined treatment. Eligible studies combined ketamine with psychotherapy in...

DOI: 10.1159/000553144 (opens in new tab) Full text (opens in new tab)

Clinical trials

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