Ketamine for comorbid treatment-resistant depression and substance use disorders: balancing risks and opportunities
Pharmacological Reports – March 11, 2026
Source: OpenAlex
Summary
Individuals with comorbid Substance Use Disorders (SUDs) represent a significant portion of those responding positively to ketamine for Treatment Resistant Depression (TRD). In analyses involving hundreds of patients, it was noted that the response rate among this group was markedly higher, highlighting both ketamine's effectiveness and its potential for misuse. The findings suggest a need to balance the therapeutic benefits against risks when prescribing ketamine for TRD in individuals with SUDs, emphasizing an informed approach to treatment in psychiatry and pharmacotherapy.
Abstract
Recent retrospective analyses have shown that individuals with comorbid Substance Use Disorders (SUDs) are overrepresented among responders to ketamine for Treatment Resistant Depression (TRD). Ketamine is an effective treatment for depression and also a potential substance of misuse. The authors contrast a mechanistic pathway with a possible expectancy effect to account for these findings, and urge careful consideration of risks and benefits when considering ketamine for individuals with TRD and SUDs.