Depression and chronic pain diagnoses in the US are at an all time high. Ketamine may be an effective treatment that can curb escalating rates, but limited research acts as a barrier to implementation. Clinicians need more information to embrace the novel treatment and optimize outcomes. The purpose of this preliminary study was to further understand the efficacy of different ketamine treatment approaches for chronic pain and depression comorbidity. 

Researchers analyzed the survey outcomes of 10 patients diagnosed with Major Depression Disorder (MDD) and a comorbid chronic pain disorder receiving two different approaches to ketamine-assisted therapy treatment: the psychedelic approach vs. the psycholytic approach. The psychedelic approach refers to high dose, intramuscular ketamine infusions that are followed by therapy sessions 24 hours later. The psycholytic approach refers to low doses of ketamine delivered sublingually via oral lozenges during therapy sessions. 

Principal findings support ketamine-assisted therapy’s efficacy for the treatment of depression and chronic pain comorbidity and indicate its potential use for anxiety and trauma-informed indications. Results suggest that the psychedelic approach may be superior to the psycholytic approach, which implies that larger doses and intramuscular routes may be optimal. Long-term trials with larger and more diverse sample sizes, randomization, and controls for route of administration/dose are necessary to make statistically significant, generalizable claims about this novel indication.