Joost Breeksema - Letting go: Patient experiences on control and care in ketamine for depression

Ketamine therapy for treatment-resistant depression is often administered in a sterile, exclusively pharmacological context that neglects essential supportive needs. Many patients experience intense, unexpected psychoactive effects and find themselves struggling with a perceived loss of control, which can become self-reinforcing and negatively impact subsequent sessions. Patients report that the quality of care, including the physical setting, presence of trusted support persons, and the ability to process their experiences, is highly variable. When these experiences are pathologized as mere side effects rather than addressed as integral to the therapeutic process, patients may feel dismissed. Integrating support and creating safer container environments is vital for maximizing the therapeutic benefits of the experience.