Ketamine administered biomedically or as psychedelic-assisted therapy in treatment-resistant depression: Differing efficacy based on depressive subtype or presence of childhood trauma?

Authors

Adam Bayes, Colleen Loo

Published in

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. Pages 10398562261494440. Oct 13, 2026. Epub Oct 13, 2026.

Abstract

ObjectiveThe ideas presented in this paper are based on a presentation at a festschrift event marking the retirement of Professor Gordon Parker from UNSW, Sydney. Drawing on Gordon's depressive subtyping approach and his critiques of a unitary view of major depressive disorder and treatment-resistant depression (TRD), we aim to (i) explore differing models of ketamine for TRD - biomedical versus 'psychedelic-assisted' therapy, and (ii) whether there may be differential efficacy in each approach based on subtype and/or childhood trauma.ConclusionPreliminary results from our study indicate in an open-label (but not randomised controlled) setting, biomedical ketamine may be superior in melancholic versus non-melancholic depression subtyped using Sydney Melancholia Prototypic Index. Studies of ketamine as a psychedelic agent combined with psychotherapy are lacking. We outline an empirical approach to determine whether ketamine with integrated psychotherapy has differential efficacy based on depressive subtype or past childhood trauma.

PMID:
42865326
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.

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