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Mindfulness, music, visual occlusion in ketamine therapy for depression: do they change outcomes? A qualitative and quantitative analysis of a randomized controlled trial

Mina Kheirkhah, Nastasia McDonald, Julia Aepfelbacher, Manivel Rengasamy, Sharvari Shivanekar, Crystal Spotts, Iya Cooper, Andrew Baumeister, Elizabeth Bell, Kevin Do-Nguyen, Mary L. Woody, Shabnam Hossein, Ioline D. Henter, Allison C. Nugent, Nadia S. Hejazi, Hamidreza Jamalabadi, Mani Yavi, Martin Walter, Carlos A. Zarate, Rebecca B. Price

Frontiers in Psychiatry September 2, 2025 Peer reviewed DOI: 10.3389/fpsyt.2025.1642025 via OpenAlex

Summary

In a randomized controlled trial with 43 participants suffering from unipolar depressive disorder, both groups showed significant improvement in depression scores after receiving ketamine. However, those who also experienced mindfulness, music, and an eye mask reported a richer emotional experience, including deeper engagement and feelings of awe. Some participants in the combined intervention group did report discomfort. The findings suggest that while ketamine's antidepressant effects are consistent, sensory interventions can enhance the subjective experience.

Study at a glance

Design randomized controlled trial
Sample size 43
Population participants with unipolar depressive disorder
Key finding Ketamine's antidepressant effects remained consistent regardless of whether additional sensory interventions were included, but these interventions enriched the emotional experience for many participants.

Abstract

Introduction: This is the first randomized controlled trial to use both qualitative and quantitative methods to evaluate the effects of a combined sensory intervention that included mindfulness, music, and a light-occluding eye mask during antidepressant-dose ketamine treatment for depression. Methods: Forty-three participants with unipolar depressive disorder enrolled in the study; 22 individuals were randomly assigned to receive mindfulness, music, and eye mask during ketamine infusion, and 21 individuals in the control group received only ketamine without additional interventions. Quantitative analyses assessed the impact of combined sensory intervention on ketamine's antidepressant effects, and qualitative analyses explored the participants' experiences. Results: Depression scores improved significantly and similarly across both groups. However, adding combined sensory interventions to ketamine infusion enriched subjective experience. More participants in the combined sensory intervention group reported deeper engagement, a stronger sense of connection to reality, increased focus on the experience rather than the strangeness of it, moments of relief from sadness, and feelings of awe and spiritual insight compared to the control group. Four individuals in the combined sensory intervention group also reported discomfort. Discussion: Ketamine's antidepressant effects remained consistent with or without combined sensory intervention; however, mindfulness, music, and eye mask made the experience more meaningful and emotionally rich for many, though it also introduced discomfort for a few-this outcome might be avoided by making these interventions optional. Given the limited research on combining ketamine with sensory interventions, these results contribute valuable insights and underscore the need for further studies to explore this combined therapeutic approach. Clinical trial registration: https://clinicaltrials.gov/study/NCT05168735, identifier NCT05168735.

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