Frontiers in Psychiatry
September 19, 2023
Nicolas Garel, Jessica Drury, Julien Thibault Lévesque et al.
32 citations
A biopsychosocial approach to ketamine for treatment-resistant depression, called the Montreal model, pairs ketamine infusions with structured psychiatric care and psychotherapy. Developed over six years in public healthcare settings, the model conceptualizes ketamine as a brief intervention that creates windows of opportunity for enhanced care and psychological growth. It combines six ketamine infusions with psychedelic-inspired nonpharmacological adjuncts, including preparative and integrative psychological support. The model aims to bridge biomedical and psychedelic perspectives, offering a standardized yet flexible approach for severe, real-world patients. Further research is needed to assess its effectiveness and hypothesized psychological mechanisms.
The British Journal of Psychiatry
June 18, 2025
Kyle T Greenway, Nicolas Garel, Lê-Anh L Dinh-Williams et al.
8 citations
In a clinical trial of ketamine combined with psychotherapy for severe treatment-resistant depression, 32 participants received six ketamine infusions with psychological support, either with or without music. Both groups showed large and sustained reductions in depression, anxiety, and suicidality at four weeks, fully maintained at eight-week follow-up. The ketamine experiences were highly emotional and mystical, comparable to those seen with psilocybin. Converging analyses suggested that mystical-like experiences contributed to the immediate and lasting antidepressant effects. Music did not enhance outcomes or psychedelic experiences.
International clinical psychopharmacology
September 1, 2023
Nicolas Garel, Michka Nazon, Kamran Naghi et al.
7 citations
A Canadian patient with severe, prolonged treatment-resistant depression who was actively requesting Medical Assistance in Dying (MAiD) experienced remission after a course of intravenous ketamine infusions. This is the first reported case of any intervention yielding remission in a patient who would otherwise likely have been eligible for MAiD for depression. The case raises questions about evaluating MAiD requests for psychiatric disorders, particularly regarding the definition of irremediability—whether a patient lacks any reasonable prospect for recovery. The authors suggest that a trial of ketamine warrants consideration in similar cases.