Ketamine-Augmented Hypnotherapy

Background/Objectives: Ketamine has rapid antidepressant effects through NMDA receptor antagonism and downstream neuroplasticity. Combined with structured psychotherapy, it is a promising but still experimental option for patients who have not responded to established treatments. By transiently loosening self-referential processing and habitual evaluative frameworks, psychoactive substances may open a window for therapeutic change. This article outlines the theoretical and neurobiological foundations of altered states of consciousness relevant to this approach. It presents ketamine-augmented hypnotherapy (KAHT) as a specific form of ketamine-assisted psychotherapy. Methods: We review the literature on psychedelic, ketamine-induced, and hypnotic states and describe the KAHT protocol. In KAHT, a single intravenous infusion of racemic ketamine (0.5 mg/kg) is given under hypnotherapeutic guidance, embedded in preparation and integration sessions. Preliminary data from 89 patients include the Mystical Experience Questionnaire (MEQ), pre–post PHQ-9 scores (n = 20), and patient-reported effects. Results: Most patients described the session as calming, euphoric, and psychedelic, with the highest MEQ ratings for transcendence of time and space. PHQ-9 scores decreased significantly (p = 0.048). In the clinically depressed subgroup (n = 14), the reduction did not reach significance (p = 0.09). Of 20 patients, 12 reported lasting positive changes, 6 no change, and 2 negative changes. Conclusions: KAHT appears feasible and may be applicable across diagnostic categories, but responses vary. The uncontrolled design cannot isolate the contribution of the hypnotherapeutic component. Randomized trials are needed to establish efficacy and predictors of response.