Keywords
Ketamine
Psychotherapy
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Abstract
Objective: To analyze the clinical evidence and neurobiological rationale for the use of ketamine-assisted psychotherapy in the treatment of treatment-resistant depression. Literature review: Treatment-resistant depression (TRD) is characterized by the persistence of depressive symptoms after the failure of at least two adequate antidepressant treatments, and is associated with functional impairment, prolonged emotional suffering, and increased risk of suicide. Conventional therapies have a slow onset of action and are insufficiently effective in about one-third of patients, highlighting the need for rapid and effective interventions. Ketamine, an NMDA receptor antagonist, has been shown to induce a rapid antidepressant response at subanesthetic doses administered intravenously or intranasally, with effects lasting days to weeks. Initial evidence suggests that ketamine may reduce relapse rates, optimize functionality, and prolong benefits, representing a paradigm shift by combining rapid symptom improvement with positive effects on quality of life and emotional resilience. Final considerations: Ketamine-assisted psychotherapy emerges as a promising strategy for TRD, offering a synergistic approach between pharmacology and psychotherapy, with the potential to redefine the clinical management of treatment-resistant depression and foster the development of new therapeutic modalities.
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