Ketamine-Assisted Psychotherapy for Treatment- Resistant Depression with Comorbid Post-Traumatic Stress Disorder in Veterans
Insight the psychological dimensions of society – November 19, 2025
Source: OpenAlex
Summary
More than 50% of veterans with treatment-resistant depression and PTSD reported significant improvement after undergoing ketamine-assisted psychotherapy (KAT) in Ukraine, demonstrating a promising approach amidst challenging circumstances. In a sample of 27 participants, symptom reduction was notable, with effect sizes of 1.31 for depression and 1.10 for PTSD. While 22-26% experienced unchanged or worsened symptoms, indicating the necessity for personalized treatment, the positive effects of KAT persisted for at least one month post-treatment, highlighting its potential in psychiatric care.
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,