Definition
A clinical protocol in which sub-anesthetic doses of ketamine are administered (IV, IM, oral, or intranasal) under medical supervision to treat depression, PTSD, anxiety, or chronic pain — typically combined with structured psychotherapy.
In Depth
Ketamine-assisted therapy refers to the medical use of ketamine, an NMDA receptor antagonist, at sub-anesthetic doses to treat psychiatric and pain conditions. Common indications include treatment-resistant depression, post-traumatic stress disorder, generalized anxiety disorder, and chronic pain.
Routes of administration include intravenous (IV) infusion, intramuscular (IM) injection, oral lozenges or troches, and intranasal sprays (esketamine, brand name Spravato, has FDA approval for treatment-resistant depression).
Best practice integrates ketamine sessions with preparation and integration psychotherapy, conducted by licensed mental-health clinicians. Treatment is contraindicated in patients with uncontrolled hypertension, certain cardiovascular conditions, or active substance use disorder.
Related Terms
Esketamine
The (S)-enantiomer of ketamine, FDA-approved as the nasal spray Spravato for treatment-resistant depression and depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior.
Ketamine
A dissociative anesthetic developed in the 1960s, now used at sub-anesthetic doses for treatment-resistant depression and other mental health conditions.
Spravato
Brand name for esketamine intranasal spray, manufactured by Janssen. FDA-approved in 2019 for treatment-resistant depression; administered only in certified clinics under a Risk Evaluation and Mitigation Strategy (REMS).
Treatment-Resistant Depression (TRD)
A subtype of major depressive disorder defined by inadequate response to at least two adequate trials of antidepressant medications from different classes.
Definition is editorial and educational; not a substitute for medical advice. See our Medical Disclaimer.