Research Publications
The Montreal Model of Ketamine-Therapy: Protocol and Theory
The Montreal Model: An Integrative Biomedical-Psychedelic Approach to Ketamine for Severe Treatment-Resistant Depression.
This article outlines the development and protocol of the Montreal Model and the team’s cumulative knowledge gained from hundreds of ketamine sessions conducted with highly severe patients with treatment resistant depression (TRD). To contextualize the model’s development, we review the evidence for ketamine as a biomedical and as a psychedelic treatment of depression, emphasizing each perspectives’ strengths, weaknesses, and distinct methods of utilization. This article details the model’s rationale, its components, the goals and activities of each session, and the postulated therapeutic mechanisms.
MUSIK Trial
The Music for Subanesthetic Infusions of Ketamine (MUSIK) randomized clinical trial was conducted between January 2021 and August 2022 in Montreal, Canada and investigated the effects of ketamine-assisted psychotherapy—with and without music—on patients with highly treatment-resistant depression (TRD). During the trial, six subanesthetic ketamine infusions were administered over four weeks to 32 participants, alongside structured psychological support.
Music as an Intervention to Improve the Hemodynamic Response of Ketamine in Depression: A Randomized Clinical Trial.
This article reports the MUSIK Trial’s primary outcome: systolic blood pressure changes. We examined the impact of music on the hemodynamic response to intravenous ketamine in patients with TRD. Given ketamine’s propensity to elevate blood pressure, the study assessed whether music, as a nonpharmacological intervention, could modulate these cardiovascular effects. Participants received subanesthetic ketamine infusions under either music or non-music conditions, with continuous monitoring of blood pressure and heart rate. Results indicated that music was associated with attenuated blood pressure increases during treatment, suggesting that music may serve as a simple and effective adjunct to improve the safety and tolerability of ketamine administration in psychiatric settings.
The Music for Subanesthetic Infusions of Ketamine Randomised Clinical Trial: Ketamine as a Psychedelic Treatment for Highly Refractory Depression.
This article reports the psychiatric outcomes of the MUSIK trial, overall and for both groups: music- and non-music conditions. Both treatment groups showed substantial and sustained improvements in depression, anxiety, and suicidality, with effects persisting at least eight weeks post-treatment. Importantly, the intensity of mystical-like experiences during sessions, not music itself, was strongly associated with greater antidepressant outcomes. These findings support the efficacy of psychedelic-like ketamine treatments and highlight the therapeutic potential of integrating psychological and contextual elements—such as set, setting, and supportive care—into ketamine-based interventions for severe depression.
Greenway KT, Garel N, Dinh-Williams LL, Lévesque JT, Kaelen M, Dagenais-Beaulé V, de la Salle S, Erritzoe D, Looper K, Turecki G, Rej S, Richard-Devantoy S. The Music for Subanesthetic Infusions of Ketamine Randomised Clinical Trial: Ketamine as a Psychedelic Treatment for Highly Refractory Depression. Br J Psychiatry. 2025;1–9. doi:10.1192/bjp.2025.102.
Benzodiazepine Cutting
Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report.
This article examines an ambi-directional cohort study we conducted of patients undergoing the Montreal Model for TRD who were taking long-term benzodiazepines (or Z-drugs) on evaluation. Participants undergoing treatment were assessed for their ability to reduce or cease benzodiazepine consumption. The study found that ketamine infusions not only alleviated depressive symptoms but also facilitated the tapering and discontinuation of benzodiazepines in a significant proportion of patients. These findings suggest that ketamine may serve a dual therapeutic role in managing TRD and assisting in benzodiazepine deprescription, offering a promising avenue for addressing the challenges of long-term benzodiazepine dependence in this population.
Imprinting
Imprinting: Expanding the Extra-Pharmacological Model of Psychedelic Drug Action to Incorporate Delayed Influences of Sets and Settings.
This article introduces the concept of “imprinting” to describe how recent environmental exposures, particularly digital media, can influence the content and emotional quality of psychedelic experiences, including those induced by ketamine. Drawing on qualitative data from a clinical trial of ketamine-assisted psychotherapy for TRD, several cases revealed that imagery and themes from media consumed days prior to treatment sessions re-emerged as vivid hallucinations, sometimes overriding therapeutic intentions and reducing the depth of mystical or emotional engagement. Additionally, an in-depth review of the literature revealed past, unrecognized examples of the imprinting phenomena with a wide variety of psychedelic drugs. These findings expand the traditional “set and setting” model by incorporating delayed contextual influences, suggesting that behavioural patterns before treatment, conscious or unconscious, may significantly shape outcomes. The concept of imprinting offers a useful framework for optimizing psychedelic therapies through more intentional and individualized preparation.
The Ketamine Chameleon
The ketamine chameleon: history, pharmacology, and the contested value of experience
Ketamine’s psychoactive effects have inspired diverse interpretations. In this review, we provide an extensive review of a neglected body of anesthesia literature that provides a unique angle to better understanding extra-pharmacological influences on ketamine’s subjective and therapeutic effects, including the remarkable power of how the drug effects are framed. We trace the historical evolution of these perspectives – which we broadly categorize as ‘dissociative,’ ‘dream-like,’ and ‘psychedelic’ – and show how they emerged out of these clinical contexts. We highlight the influence of factors such as language, dose, and environmental context on ketamine’s effects and therapeutic outcomes. We discuss potential mechanisms underlying these context-dependent effects and explore the broader clinical and research-related ramifications.
English 
French