Patients' Voices on Ketamine for Treatment-Resistant Depression: A Narrative Review of Qualitative Perspectives.

Abstract

Treatment-resistant depression (TRD) remains a significant public-health challenge, with many patients failing to respond to conventional therapies. Ketamine has emerged as a rapid-acting intervention, but quantitative outcomes alone do not capture patients' lived experiences, which shape engagement, acceptability, and adherence. We conducted a narrative review of qualitative and mixed-methods studies to enable conceptual integration and thematic synthesis of patients' experiences with ketamine treatment for depression, guided by established narrative review methodology and the SANRA framework. A targeted search of MEDLINE and Scopus (November 2025) identified studies reporting adult patients' perspectives on therapeutic ketamine or esketamine use, with qualitative data synthesized iteratively in keeping with narrative review principles. Across the literature, patients' perspectives coalesce around key thematic domains, including motivations and expectations for treatment, the phenomenology of the treatment experience, post-treatment trajectories, side effects and reasons for discontinuation, relational and environmental factors, and information and education needs. By focusing on these thematic groups, the review highlights the experiential dimensions that influence the perceived value and acceptability of ketamine, underscoring the need for patient-centered service design. Integrating these insights can guide the development of ketamine programs that are both evidence-based and aligned with patients' priorities and perspectives.

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