Abreactive ketamine psychotherapy (historical)

Domain VII · Transpersonal, psychedelic & altered states · Enayat Khorramzadeh, Atta Ollah Lotfy · 1973 · Shiraz, Iran

What it is

HISTORICAL — NOT FOR USE. This tab describes a 1970s inpatient research procedure so that clinicians can recognise it, place historical and present-day claims about it, and support clients. It is not a protocol. No doses, routes, rates or schedules of administration are given, deliberately. Any…

Format

• Session count: most patients had a single drug-assisted session; two asked for and received a second at follow-up, and the two non-improvers at one year were given a repeat session with reported short-lived relief.
• Design limits: as read in the paper, there was no comparison group, no blinding and outcome was the clinicians' own judgement. Mathai et al. (2022) describe the series as non-randomised; their wording on whether it was controlled differs from the paper as I read it.

Who practises it, and how they are trained or regulated

• The 1973 procedure has no current licensed equivalent. Present-day ketamine treatment, where clients may meet it:
• United States: ketamine is Schedule III. Esketamine (Spravato) is FDA-approved for treatment-resistant depression (2019) and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behaviour (2020); it may only be given in REMS-certified settings whose staff can manage physiological and dysphoric reactions, with medical monitoring and a post-session observation period handled…
• Version followed: Khorramzadeh & Lotfy (1973), "The Use of Ketamine in Psychiatry", Psychosomatics 14:344–346 (Shiraz, Iran; 100 inpatients), read in full via the MAPS bibliography copy; secondary context from Mathai, Mora & Garcia-Romeu (2022) and Drozdz et al. (2022). Present-day frame from regulator, clinic-consent and memory-research sources listed below.

Evidence status, as the guide reports it

• Design limits: as read in the paper, there was no comparison group, no blinding and outcome was the clinicians' own judgement. Mathai et al. (2022) describe the series as non-randomised; their wording on whether it was controlled differs from the paper as I read it.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• clinics without on-site medical staff or screening, or that promise memory recovery; refer elsewhere.
• symptom worsening without recovery between sessions; adjust pace. Working when intrusions and avoidance decrease over sessions.
• urinary symptoms, escalating use, using alone, dissociation persisting between uses. Working when the client engages with safer care.
• a client set on proving a specific event; consider whether ketamine treatment fits their goals and discuss with the prescriber. Working when the client can state realistic expectations.
• shame, anger at former clinicians, or loyalty to them; do not rush to call the treatment harmful or helpful. Working when the client can tell the story at their own pace without overwhelm.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.