Ketamine-assisted psychotherapies for mental disorders: A historical overview and systematic review

IF 11.2 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2026-03-01 Epub Date: 2026-02-02 DOI:10.1016/j.cpr.2026.102706

J.K.E. Veraart , N. Schimmers , J.J. Breeksema , C. Seybert , J. Kamphuis , L.F.T. Huber , A. Rota , D.T. Coerts , A.J. Oliveira-Maia , R.A. Schoevers

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Abstract

Introduction

Ketamine-assisted psychotherapy (KAP) is considered a promising treatment strategy in psychiatric disorders, combining psychotherapeutic interventions with the rapid-acting pharmacological effects of ketamine towards enhancing outcomes. Although KAP has been practiced for many years across different diagnoses, evidence regarding optimal treatment methods and working mechanisms remains limited and has only partly been synthesized.

Methods

This systematic review provides a historical overview of studies published up to 2025, that combined ketamine and psychotherapy for the treatment of mental disorders. Psychotherapeutic approaches were categorized into their overarching psychological paradigms: psychoanalytic and psychodynamic, behavioral, humanistic, cognitive-behavioral, integrative/holistic, and other therapeutic frameworks.

Results

64 articles, reporting on 72 studies, were included in this review, of which only 11 were randomized controlled trials (RCTs), highlighting the limited representation of RCTs in the overall body of evidence. Diverse therapeutic approaches were found, most were classified into the ‘other’ category (n = 24). Results suggest transdiagnostic effectiveness for indications including major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, substance use disorders and eating disorders. KAP, compared to only psychotherapy, was observed to enhance treatment engagement, symptom reduction, and duration of treatment response. Only two studies randomized psychotherapy in the context of ketamine treatment, neither of which reported added effects for psychotherapy. One of those studies also randomized ketamine and did not find a significant interaction effect. This limited evidence does not support added benefit from psychotherapy nor evidence of synergy. Methodological heterogeneity and the limited number of trials that used a psychotherapy control group, restrict definitive conclusions.

Discussion

Clinical effects are generally reported to be quite positive across psychiatric indications, however, there is a clear need for well-controlled trials to test for potential additive or synergistic effects of the combined use of ketamine and psychotherapy and to identify optimal therapeutic protocols.

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氯胺酮辅助精神障碍的心理治疗：历史回顾和系统回顾

氯胺酮辅助心理治疗（KAP）被认为是一种很有前途的精神疾病治疗策略，将心理治疗干预与氯胺酮的速效药理作用相结合，以提高疗效。尽管KAP已经在不同的诊断中实践了多年，但关于最佳治疗方法和工作机制的证据仍然有限，而且只是部分合成。方法本系统综述了截至2025年发表的有关氯胺酮与心理治疗联合治疗精神障碍的研究的历史概况。心理治疗方法被分类为主要的心理范式：精神分析和心理动力学、行为、人本主义、认知-行为、综合/整体和其他治疗框架。结果本综述共纳入64篇文章，报告了72项研究，其中只有11项是随机对照试验（rct），突出了rct在整个证据体中的代表性有限。发现了多种治疗方法，大多数被归类为“其他”类别（n = 24）。结果表明，该方法对重度抑郁症、创伤后应激障碍、强迫症、物质使用障碍和饮食障碍等适应症具有较好的诊断效果。与单纯的心理治疗相比，观察到KAP可以提高治疗参与度、症状减轻和治疗反应持续时间。只有两项研究在氯胺酮治疗的背景下随机进行心理治疗，没有一项研究报告对心理治疗有额外的效果。其中一项研究也将氯胺酮随机化，并没有发现显著的相互作用。这一有限的证据不支持心理治疗的额外益处，也不支持协同作用的证据。方法学的异质性和使用心理治疗对照组的试验数量有限，限制了明确的结论。据报道，临床效果在精神适应症中是相当积极的，然而，显然需要进行良好的对照试验，以测试氯胺酮和心理治疗联合使用的潜在附加或协同效应，并确定最佳治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.