{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:08:19Z","timestamp":1792519699520,"version":"4.5.0"},"reference-count":42,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec id=\"S0007125025001023_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ketamine exerts potent but transient antidepressant effects in treatment-resistant depression (TRD). Combinations of ketamine and psychotherapy have attracted interest, but no trial has investigated a psychedelic model of ketamine\u2013psychotherapy for TRD to our knowledge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025001023_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This secondary analysis of a randomised clinical trial (RCT) explores the therapeutic effects and experiential mechanisms of the Montreal Model of ketamine\u2013psychotherapy for TRD, with or without music.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025001023_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A two-centre, single-blinded, RCT conducted in Montreal, Canada, between January 2021 and August 2022 (NCT04701866). Participants received ketamine\u2013psychotherapy for TRD \u2013 six subanaesthetic infusions over 4 weeks and psychological support \u2013 with either music or matched non-music support during ketamine doses, as per random group assignments. The primary therapeutic outcome was the Montgomery\u2013\u00c5sberg Depression Rating Scale, assessed by blinded raters. Psychedelic-like experiences, evaluated by the Mystical Experience Questionnaire and Emotional Breakthrough Inventory, and their session-by-session relationships with depression were explored with multilevel, time-lagged covariate models with autoregressive residuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025001023_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two participants with severe and highly comorbid TRD, including high rates of personality disorder and suicidality, received 181 ketamine infusions. Therapeutic outcomes and psychedelic experiences did not differ between music (\n                      <jats:italic>n<\/jats:italic>\n                      = 15) and non-music (\n                      <jats:italic>n<\/jats:italic>\n                      = 17) interventions. Both groups experienced significant reductions in clinician-rated and self-reported depression (\n                      <jats:italic>d<\/jats:italic>\n                      = 1.2 and\n                      <jats:italic>d<\/jats:italic>\n                      = 0.87, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), anxiety (\n                      <jats:italic>d<\/jats:italic>\n                      = 0.8,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) and suicidality (\n                      <jats:italic>d<\/jats:italic>\n                      = 0.4,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05) at 4 weeks, fully maintained at 8-week follow-up. Ketamine experiences were highly emotional and mystical. Converging analyses supported mystical-like ketamine experiences as mechanisms of its antidepressant effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0007125025001023_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This trial found large and notably sustained benefits of ketamine\u2013psychotherapy for severe TRD, with or without music,\u00a0and psychedelic experiences of comparable intensity to those observed with psilocybin. Mystical-like experiences may particularly contribute to ketamine\u2019s immediate and persistent psychiatric benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.102","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T03:52:38Z","timestamp":1750218758000},"page":"437-445","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["The Music for Subanesthetic Infusions of Ketamine randomised clinical trial: ketamine as a psychedelic treatment for highly refractory depression"],"prefix":"10.1192","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7829-493X","authenticated-orcid":false,"given":"Kyle T.","family":"Greenway","sequence":"first","affiliation":[{"name":"McGill University"},{"name":"Lady Davis Institute, Jewish General Hospital,"},{"name":", Centres for Neuropsychopharmacology and Psychedelic Research, Imperial College 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Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}