[Ketamine Augmented Psychotherapy (KAP) in mood disorder: User guide].

Ketamine, a fast-acting antidepressant, produces dissociative effects and promotes brain plasticity. Although preliminary studies suggest combining it with psychotherapy may be beneficial, clinical antidepressant use rarely includes per- and post-infusion therapy. The psychodysleptic experiences and synaptogenic effects could enhance cognitive behavioral therapy. This article proposes a practical protocol for Ketamine Augmented Psychotherapy (KAP), synthesizing literature and clinical experience. It details four steps: preparation, administration, integration, and prolongation, and discusses limits and prospects for mood disorder management.

Study at a glance

Abstract

Ketamine, a non-competitive NMDA receptor antagonist, is used as a fast-acting antidepressant therapy in depressive disorders. This treatment provokes dissociative effects associating derealization and depersonalization, and a synaptogenic signaling cascade promoting brain plasticity. Despite several preliminary studies suggesting the usefulness of its combination with psychotherapy, administration of ketamine isn't generally combined with per- and post-infusion psychotherapy protocols in its clinical antidepressant use. However, the phenomenology of psychodysleptic experiences and the synaptogenic effect could potentiate cognitive and behavioral therapies (CBT). In this article, we purpose a practical protocol to Ketamine Augmented Psychotherapy (KAP) synthesizing contemporary data from the literature and our clinical experience. We detail proposals for clinical practice, and propose four important steps for the use of a psychodysleptic molecule for antidepressant purposes: preparation, administration, integration, and prolongation. Finally, we discuss the limits and prospects of this combination in the management of mood disorders.