VR during ketamine sessions shows feasibility and tolerability in retrospective chart review

A retrospective chart review has found that adding virtual reality therapy to ketamine treatment for depression and trauma-related psychopathology is feasible and tolerable, with clinical outcomes broadly comparable to ketamine treatment delivered without VR. The study, published in Discover Mental Health, examined patients who received a ketamine treatment course with or without adjunct VR and had both baseline and post-treatment symptom assessments.

The researchers note that ketamine is an important intervention for severe depression and trauma-related psychopathology, but the optimal way to provide therapeutic support during treatment remains unclear. Although ketamine-assisted psychotherapy is clinically appealing, maintaining therapist presence throughout every dosing session can be logistically difficult. Virtual reality may offer a structured, scalable, therapist-sparing adjunct delivered during ketamine sessions while preserving a therapeutic frame.

Of 69 patients with a documented ketamine course, 28 met the study’s inclusion requirement and formed the analytic cohort: 19 were treated with VR and 9 without VR. The primary outcomes were feasibility and tolerability, assessed using treatment-course burden and chart-documented adverse effects, with vital signs monitored during each session. Secondary outcomes were changes in PHQ-9, GAD-7, PCL-5, and PSS scores from baseline to follow-up.

Statistically, within-group change was tested with Wilcoxon signed-rank tests, and between-group comparisons used Mann-Whitney U tests. Adjunct VR was associated with low rates of adverse effects and a treatment course length comparable to the no-VR group. Within the VR cohort, significant improvement was observed across all symptom measures.

However, between-group analyses did not show significant differences after correction for multiple testing. The authors therefore conclude that these findings suggest VR is a feasible and tolerable adjunct to ketamine treatment, with clinical outcomes broadly comparable to treatment without VR.

Several limitations should be kept in mind when interpreting the results. The study was a retrospective chart review rather than a randomized controlled trial, and the analytic cohort was small, particularly the no-VR comparison group of nine patients. The secondary clinical outcomes were described as exploratory, and the absence of significant between-group differences after multiple-testing correction means the study does not establish that VR improves outcomes relative to standard care. The clinical trial number was listed as not applicable.

Within these constraints, the work addresses a practical question in the delivery of ketamine-based care: whether a scalable, technology-supported adjunct can be used during dosing sessions without adding burden or adverse effects. In this cohort, the answer on feasibility and tolerability was positive, while the question of comparative clinical benefit remains open to further study.

Subject of Research: Feasibility and tolerability of adjunct virtual reality therapy during ketamine treatment for PTSD and depression

Article Title: Virtual reality therapy is a feasible and tolerable adjunct to ketamine treatment for PTSD and depression

Article References: Rubaye, S., Shah, A., Aldulaimy, W., & Hernandez, A. (2026). Virtual reality therapy is a feasible and tolerable adjunct to ketamine treatment for PTSD and depression. Discover Mental Health. https://doi.org/10.1007/s44192-026-00643-w

Image Credits: AI Generated

DOI: 10.1007/s44192-026-00643-w

Keywords: virtual reality, ketamine, PTSD, depression, retrospective chart review, feasibility, tolerability, PHQ-9, GAD-7, PCL-5, ketamine-assisted psychotherapy, mental health