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.
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
November 1, 2023
Nicolas Garel, Kyle T Greenway, Lê-Anh L Dinh-Williams et al.
10 citations
A course of six sub-anesthetic ketamine infusions over four weeks helped patients with treatment-resistant depression discontinue long-term benzodiazepine or z-drug use. Of 22 patients, 91% (20/22) successfully stopped all such medications by the end of the infusions, confirmed by urine tests. Fewer than 25% experienced significant worsening of anxiety, depression, sleep problems, or suicidality during withdrawal. Over a mean follow-up of one year, 64% (14/22) remained abstinent. These preliminary results suggest ketamine infusions may facilitate benzodiazepine deprescription even in patients with active depression and significant comorbidity.
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.
Psychological medicine
May 8, 2026
Lou-Anne Chavigny, Véronique Desbeaumes Jodoin, Nicolas Garel et al.
A systematic review of 21 studies involving approximately 900–1,180 participants with treatment-resistant depression found that low-dose intravenous ketamine preserves and enhances certain cognitive functions. Improvements were frequently observed in processing speed and working memory, while attention remained stable or modestly improved. Results for verbal and visual memory varied across studies. Executive control, especially inhibitory performance on Stroop tasks, improved in several trials. No cognitive worsening was reported. Two studies directly examined cognition in relation to suicidal behaviors, suggesting that procognitive effects, particularly in executive control, may mediate ketamine's antisuicidal action. Standardized longitudinal studies are needed to clarify durability and clinical significance.