Patients' recovery and non-recovery narratives after intravenous ketamine for treatment-resistant depression

Adrienne Lapidos, Daniela Lopez-Vives, Cortney E. Sera, Elizabeth Ahearn, Erica Vest, Ivana Senic, Jennifer L. Vande Voort, Mark Frye, Fernando S. Goes, Eric Achtyes, John Greden, Sagar V. Parikh

Research output: Contribution to journalArticlepeer-review


Background: Intravenous (IV) ketamine is an effective therapy for treatment-resistant depression. A large data base is confirmatory and steadily expanding. Qualitative studies can inform best practices and suggest new research directions. As part of a clinical trial designed to identify biomarkers of ketamine response, a qualitative study was conducted to characterize experiences with: receiving infusions; recovering or not recovering from depression; and beliefs about why ketamine worked or did not work. Methods: Adults with treatment-resistant depression received three IV ketamine infusions in a two-week period and were characterized as remitters or non-remitters via symptom reduction 24 h after the third infusion. Qualitative interviews of a subset of participants were audio recorded, transcribed verbatim, and coded using deductive and inductive methods. Themes were derived and compared across a broader construct of recovery status. Results: Of the 21 participants, nine (43 %) were characterized as having experienced remission and 12 (57 %) non-remission. Of the 12 non-remitters, five were characterized as having experienced partial recovery based on their subjective experiences, reporting substantial benefit from ketamine infusions despite non-remission status based on scale measurements. Attributions for ketamine's effects included biological and experiential mechanisms. Among non-remitters there was risk of disappointment when adding another failed treatment. Limitations: A more diverse sample may have yielded different themes. Different patients had different amounts of time elapsed between ketamine infusions and qualitative interview. Conclusions: Qualitative methods may enhance researchers' characterization of IV ketamine's impact on treatment-resistant depression. While requiring confirmation, patients may benefit from a preparatory milieu that prepares them for multiple recovery pathways; decouples the psychedelic experience from clinical outcomes; and addresses potential risks of another failed treatment.

Original languageEnglish (US)
Pages (from-to)534-539
Number of pages6
JournalJournal of Affective Disorders
StatePublished - Feb 15 2023


  • Intravenous ketamine
  • Qualitative methods
  • Recovery
  • Remission
  • Treatment-resistant depression

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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