Clinicians measure success in symptom scores and receptor occupancy, but for patients with Treatment-Resistant Depression (TRD), success is defined by something far more personal: the return of connection, clarity, and “life.” In this episode, we amplify the “Patient’s Voice” through a comprehensive synthesis of qualitative studies by Walasek and colleagues.

We trace the emotional arc of treatment, starting with the profound ambivalence of patients who see ketamine as a “last resort”—terrified it will be just another failure in a long line of disappointments. We then step inside the acute experience itself, often described as a “rollercoaster” where euphoria and panic can flip on a dime, making the safety of the setting and the empathy of the staff critical to preventing trauma.

The discussion challenges the medical model’s obsession with dissociation as a measurable “active ingredient,” revealing that patients value the meaning they make of the experience—the moments of insight and emotional release—far more than the intensity of the “trip” itself. Finally, we expose the hidden barriers to care: the crushing financial burden, the stigma of using a “party drug,” and the finding that patients often attribute up to 50% of their therapeutic outcome not to the molecule, but to the kindness and support of the clinical staff.

Reference:

Walaszek, M., Cubała, W. J., & Kachlik, Z. (2025). Patients’ voices on ketamine for treatment-resistant depression: A narrative review of qualitative perspectives. Journal of Clinical Medicine.

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