Ketamine and psychotherapy for the treatment of psychiatric disorders: Systematic review
Open accessAbstract
BACKGROUND: Ketamine is an effective short-term treatment for a range of psychiatric disorders. A key question is whether the addition of psychotherapy to ketamine treatment improves outcomes or delays relapse. AIM: To identify all studies combining psychotherapy with ketamine for the treatment of psychiatric disorders to summarise their effects and make recommendations for future research. METHOD: The review protocol was prospectively registered with PROSPERO (registration number CRD42022318120). Potential studies were searched for in MEDLINE, Embase, PsycINFO, SCOPUS, the Cochrane library and Google Scholar. Eligible studies combined ketamine and psychotherapy for the treatment of psychiatric disorders and did not use case reports or qualitative designs. Key findings relating to psychotherapy type, diagnosis, ketamine protocol, sequencing of psychotherapy and study design are reported. Risk of bias was assessed using modified Joanna Briggs critical appraisal tools. RESULTS: Nineteen studies evaluating 1006 patients were included in the systematic review. A variety of supportive individual and group, manualised and non-manualised psychotherapies were used. The majority of studies evaluated substance use disorders, post-traumatic stress disorder and treatment-resistant depression. Ketamine protocols and sequencing of ketamine/psychotherapy treatment varied substantially between studies. Outcomes were largely positive for the addition of psychotherapy to ketamine treatment. CONCLUSION: The combination of psychotherapy and ketamine offers promise for the treatment of psychiatric disorders, but study heterogeneity prevents definitive recommendations for their integration. Larger randomised controlled trials using manualised psychotherapies and standardised ketamine protocols are recommended to clarify the extent to which the addition of psychotherapy to ketamine improves outcomes over ketamine treatment alone.
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The evidence suggests that the future may lie in integrative models, combining fast-acting agents (e.g., ketamine, buprenorphine) with structured psychotherapeutic work on meaning and tolerability.
“The evidence suggests that the future may lie in integrative models, combining fast-acting agents (e.g., ketamine, buprenorphine) with structured psychotherapeutic work on meaning and tolerability [79].”
From Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol (2026) · cites this paper as [79]
The Conclusion (page unavailable) says combining ketamine with psychotherapy offers promise and recommends further trials using manualised psychotherapies. The cited review does not establish the same approach for buprenorphine or specifically describe psychotherapy as work on meaning and tolerability; it also says heterogeneity prevents definitive recommendations for integration. (LLM, conf=0.86)
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Targeting Psychological Pain After a Suicide Attempt: Scoping Review and Intervention Protocol
Comendador, L., Palao, D. J., Sanz, A., Andreo-Jover, J., Baca-García, E., Barrigón, M. L., Bobes-Bascarán, M. T., Botí, M. Á., Diaz-Marsá, M., Elices, M., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15083124 · Cited by 2 · see citing works
“The evidence suggests that the future may lie in integrative models, combining fast-acting agents (e.g., ketamine, buprenorphine) with structured psychotherapeutic work on meaning and tolerability [79].”
- Authors
- Kew, B. M., Porter, R. J., Douglas, K. M., Glue, P., Mentzel, C. L., & Beaglehole, B.
- Affiliations
- University of Otago (NZ)
- Corresponding author
- Beaglehole, Ben
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2023-05
- Volume
- 9
- Issue
- 3
- Pages
- e79-e79
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC10228275
- OpenAlex
- W4367668878
- Cited by
- 69
- References
- 51
- Citations by year
- 2026: 22 · 2025: 15 · 2024: 26 · 2023: 6
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BJPsych Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- ketamine, psychotherapy, combination therapy, mental illness, substance use disorders, post-traumatic stress disorder, treatment-resistant depression, relapse prevention, treatment sequencing
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