Patients Are Asking About Ketamine for Functional Neurological Symptoms. Here Is What to Tell Them
Patients with functional seizures and functional movement symptoms are calling ketamine clinics, often after reading a case report. A systematic review in Frontiers in Psychiatry has now gathered the whole literature in one place. That makes the question much easier to answer well.
The inquiries a clinic declines still take staff time to answer well. HealingMaps’ GPO, the first built for the ketamine industry, gets member clinics 40 percent or more off medical supplies, 15 to 20 percent off malpractice and liability premiums, discounted LegitScript certification, and 20 to 30 percent off HIPAA compliant payment processing. Joining is free with no obligation. See what your clinic qualifies for →
| Key Takeaway | Detail |
|---|---|
| The review | 13 studies of (es)ketamine in functional neurological disorder, published July 20 |
| Who wrote it | Neuropsychiatry teams at St George’s, UCL, King’s College London and Melbourne |
| What was reported | Improvement in functional motor symptoms, dissociative seizures and other presentations |
| Tolerability | Mostly mild and transient, with perceptual effects resolving in one to two hours |
| The evidence stage | Case reports and small series. No controlled trial exists yet |
| The defensible line | A question worth studying, not an established treatment to market |
Why the Calls Are Coming
Functional neurological disorder covers symptoms that are real and disabling. They do not map to structural damage in the nervous system.
The presentations in this review include functional dissociative seizures, functional movement disorder, dissociative amnesia and paradoxical vocal cord motion.
It is common, it is disabling, and effective treatments remain limited. Patients in that position look hard for options, and ketamine clinics are a natural place to call.
There is a second reason the calls land with ketamine providers specifically. Several of these presentations sit at the border of neurology and psychiatry, and patients often feel handed back and forth between them.
What the Review Found
The team searched PubMed, PsycINFO and Google Scholar through December 2025 and identified 13 studies covering 70 individuals.
The reported outcomes are encouraging. Authors described improvement in functional motor symptoms, in dissociative seizures and in other functional presentations.
Those improvements frequently arrived alongside reductions in depressive and trauma-related symptoms. That is a clinically interesting pattern in its own right.
Tolerability looked good. Adverse effects were mostly transient and mild. Dissociative or perceptual symptoms typically resolved within one to two hours in supervised settings.
Why the Authors Stop Short of Recommending It
The evidence is at an early stage, and the reviewers are careful about what that supports.
Nine of the 13 studies are single case reports. Two are historical narcoanalytic reports. One is a small case series, and one surveys people using ketamine on their own.
No controlled trial has been run in this population. Only one study used an outcome measure built and validated for FND.
Doses and routes varied widely, spanning intravenous, intramuscular, intranasal, subcutaneous and sublingual administration. That range makes the studies hard to compare with each other.
FND is also known to respond to expectation and to the therapeutic relationship. That raises the bar for what uncontrolled observation can establish.
Their conclusion is that the evidence is insufficient to establish efficacy, and that the question deserves proper study.
The reviewers are also candid about their own method. A single reviewer screened titles and abstracts, which they flag as a possible source of selection bias.
They planned no meta-analysis, because the studies were too different to pool. The synthesis is narrative by necessity.
What a Clinic Can Say
This review makes a clean, defensible answer possible, and that is its practical value.
What is supportable: a small published literature describes improvement. Tolerability looks acceptable under supervision, and researchers consider the question worth investigating.
What is not: that ketamine is an established treatment for functional neurological disorder. No controlled trial has tested it.
Saying both halves plainly tends to land well. Patients who have read a case report want to know what it means. A straight answer builds more trust than either hype or dismissal.
It also keeps a referring neurologist comfortable sending the next patient.
Where the Treatable Problem Often Is
The review notes that improvements often appeared alongside reductions in depression and trauma symptoms. That points somewhere useful.
Many patients with FND also carry a mood disorder. That is an indication with a real evidence base behind it.
Treating a diagnosed comorbid depression is well supported and straightforward to defend. It is another case of matching the claim to the indication.
That path serves the patient without outrunning the data, and it keeps the clinic on solid ground.
It is worth knowing what a real answer would require. A controlled trial in this population needs a credible comparator and an FND-specific outcome measure.
Only one study in this review used such a measure. That is the gap the field has to close before anyone can claim efficacy either way.
Protocol Notes Worth Keeping
Two practical points follow from how this literature is built.
Route matters. The published cases used five different routes. Evidence gathered under one route does not automatically transfer to another, a point we have raised about oral ketamine in depression as well.
Document the reasoning. Treating outside a well established indication is defensible when the rationale is written down. That is the first item in our list of 8 gaps that create malpractice exposure.
The Bottom Line
A respected group of neuropsychiatrists reviewed every published case of ketamine in functional neurological disorder. They concluded the question deserves a real trial.
That is a reasonable place for a young area of research to sit. It also gives clinics something concrete to tell the patients who ask.
Patients looking for supervised care can start with our directory of verified ketamine clinics.
This article is for informational purposes and is not medical advice. Ketamine is not FDA approved for the treatment of functional neurological disorder.
