Functional neurological disorders (FNDs) are common, disabling neuropsychiatric conditions with limited treatment options. They present with sensory or motor symptoms that mimic other neurological conditions but arise from mechanisms other than identifiable structural neuropathology, often triggered by psychological factors. Preliminary evidence supports psychedelic-assisted therapy for several psychiatric illnesses, including FNDs. This review examines theoretical arguments for and against exploring psychedelic-assisted therapy for FNDs, discusses prior cases of psychedelic use for psychosomatic conditions, and analyzes therapeutic outcomes through recent neuroimaging studies on psychedelics and FNDs.
In adults with treatment-resistant depression, esketamine nasal spray combined with an oral antidepressant leads to higher remission rates than quetiapine extended-release combined with an oral antidepressant. Starting at week 8, 28.3% of esketamine-treated patients achieved remission compared to 18.6% on quetiapine, and by week 32, 55.7% versus 36.3%. Depressive symptoms improved more with esketamine from day 8 onward. Fewer patients stopped treatment due to side effects with esketamine (4.5%) than with quetiapine (10.1%). These results come from a secondary analysis of a randomized trial.