Journal of Pain Research (Jun 2022)
Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature
Abstract
Sandra J Drozdz,1 Akash Goel,1– 3 Matthew W McGarr,4 Joel Katz,3,5– 7 Paul Ritvo,5,7 Gabriella F Mattina,1 Venkat Bhat,8– 10 Calvin Diep,3 Karim S Ladha1,3,10 1Department of Anesthesia, St. Michael’s Hospital, Toronto, ON, Canada; 2Department of Anesthesiology, Pain and Perioperative Medicine, Stanford University, Stanford, CA, USA; 3Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; 4Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; 5Department of Psychology, York University, Toronto, ON, Canada; 6Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada; 7School of Kinesiology and Health Science, York University, Toronto, ON, Canada; 8Interventional Psychiatry Program, St. Michael’s Hospital, Toronto, ON, Canada; 9Department of Psychiatry, University of Toronto, Toronto, ON, Canada; 10Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, CanadaCorrespondence: Karim S Ladha, St. Michael’s Hospital, 30 Bond St, 6th Floor Donnelly Wing, Toronto, ON, ON, Canada, Tel +1 416-864-6060 ext. 49308, Fax +1 416-864-6014, Email [email protected]: Currently, ketamine is used in treating multiple pain, mental health, and substance abuse disorders due to rapid-acting analgesic and antidepressant effects. Its limited short-term durability has motivated research into the potential synergistic actions between ketamine and psychotherapy to sustain benefits. This systematic review on ketamine-assisted psychotherapy (KAP) summarizes existing evidence regarding present-day practices. Through rigorous review, seventeen articles that included 603 participants were identified. From available KAP publications, it is apparent that combined treatments can, in specific circumstances, initiate and prolong clinically significant reductions in pain, anxiety, and depressive symptoms, while encouraging rapport and treatment engagement, and promoting abstinence in patients addicted to other substances. Despite much variance in how KAP is applied (route of ketamine administration, ketamine dosage/frequency, psychotherapy modality, overall treatment length), these findings suggest psychotherapy, provided before, during, and following ketamine sessions, can maximize and prolong benefits. Additional large-scale randomized control trials are warranted to understand better the mutually influential relationships between psychotherapy and ketamine in optimizing responsiveness and sustaining long-term benefits in patients with chronic pain. Such investigations will assist in developing standardized practices and maintenance programs.Keywords: addiction, alternative treatment, anesthesia, chronic pain, mental health, novel therapeutic
