Can Ketamine Therapy Help With Anhedonia? New Outcomes Data, Comparisons and How It Works

What Is Anhedonia? Loss of Interest and Pleasure in Depression

You can still name the things you love. You know a walk with a friend should feel good, that a favorite album used to lift you, that finishing something hard used to feel like it counted. The knowledge is all there. The feeling that used to come with it is not.

That is anhedonia: the loss of interest or pleasure in things you used to enjoy. It is one of the two core symptoms of depression, alongside low mood, and one of the most common, showing up in about 70% of people with major depression (Wu et al., 2025).⁹ Unfortunately, it is also one of the stickiest symptoms of depression. It often lingers even after treatment lifts mood or eases other symptoms, and more severe anhedonia at the start of treatment tends to predict poorer results.⁹

Anhedonia symptoms tend to show up in three ways, and you may recognize one more than the others (Wu et al., 2025):⁹

• Anticipatory: nothing on the calendar feels worth looking forward to, even plans you once would have counted down to.
• Consummatory: you are at the dinner, the concert or on the couch with someone you love, and it lands flat while it is happening.
• Motivational: the drive to start is missing, so even things you would probably enjoy never get off the ground.

None of this is a character flaw or a lack of effort. It reflects how depression affects the brain's reward system, which later sections explain.

Anhedonia also deserves to be taken seriously. In one meta-analysis of 15 studies, people with anhedonia were more likely to have current suicidal thoughts, even after accounting for how severe their depression was (Ducasse et al., 2018).¹⁰ If you are having thoughts of suicide or self-harm, call or text 988 to reach the Suicide and Crisis Lifeline in the US.

Anhedonia Treatment: Why Standard Antidepressants Often Fall Short

If your mood has lifted on an antidepressant but things still feel colorless, you are not imagining it. No treatment is approved specifically for anhedonia, so it is usually treated as part of depression with standard antidepressants, talk therapy or brain stimulation (France, 2025).¹¹ One systematic review notes that conventional antidepressants have limited effects on reward processing and motivation, the brain functions anhedonia disrupts (Faisal et al., 2026).¹²

Emotional Blunting on SSRIs and Other Antidepressants

Some people describe something different on antidepressants: everything feels dulled, the highs along with the lows. In one survey of 669 people treated for depression, 46% reported this emotional blunting (Goodwin et al., 2017).¹³ The researchers note that blunting can also be part of depression itself, not only a medication effect.

That is why researchers have looked at treatments that work on the brain's reward system in a different way, including ketamine.

Can Ketamine Therapy Help With Anhedonia?

Yes. In a 2024 systematic review of 22 studies, every study reported less anhedonia after ketamine or esketamine (Kwaśny et al., 2024).²² In addition, Mindbloom's new analysis of 20,931 patients provides yet another reference point for ketamine's efficacy in relieving anhedonia (Carter et al., 2026).¹ Mindbloom patients who started at-home ketamine therapy with moderate to severe anhedonia (present most days) saw its severity drop 58% on average by Session 6, about six weeks in.¹

The researchers measured anhedonia with the PHQ-9 question that covers this dimension of depression: how often, over the past two weeks, a person has had "little interest or pleasure in doing things." They followed the 20,931 patients who answered "more than half the days" or "nearly every day" at the start, and tracked how that answer changed.¹ Among the 1,565 who completed the Session 6 check-in:

• Severity of anhedonia dropped 58% on average.¹
• 78% went from experiencing anhedonia most days to only occasionally or not at all (Mindbloom analysis of Carter et al., 2026).²
• 89% improved, meaning their answer dropped by at least one step on the 0 to 3 scale.¹
• About 1 in 5 (21%) reported complete resolution of their anhedonia, meaning it was no longer something they experienced at all.¹

The change built steadily across the course. In the full analysis of all nine PHQ-9 symptoms, anhedonia improved as much as low mood, the other core symptom of depression: both dropped 58% on average.¹

_{Real-world preprint data (Carter et al., 2026). 20,931 patients at the start; 1,565 completed the Session 6 check-in.}

These results come from a retrospective analysis of real-world, patient-reported outcomes, posted as a preprint in October 2026.¹ Patients took ketamine as sublingual tablets or by subcutaneous injection, and results were combined across both. Because PHQ-9 Item 1 is a single question rather than a full anhedonia scale, some of the change may reflect mood improving overall.

Ketamine Therapy vs. Other Anhedonia Treatments: Antidepressants, Esketamine and TMS

On the same PHQ-9 question, Mindbloom's at-home ketamine therapy results on anhedonia were comparable to esketamine and TMS, and higher than those reported for antidepressants.

Same PHQ-9 Question

• Antidepressants. By Session 6, 78% of patients went from anhedonia most days to only occasionally or not at all.² That is higher than the 41% to 51% reported for people who added a placebo to their SSRI or SNRI in two phase 3 trials.⁵⁻⁶
• Esketamine (Spravato). By Session 6, 89% had improved.¹ That is comparable to the 85% who improved after four weeks of esketamine plus a new antidepressant, and higher than the 69% who started the same new antidepressant with a placebo spray instead (Floden et al., 2022).³
• TMS. By Session 6, anhedonia severity dropped 58% on average.¹ That is comparable to the 52% drop after a full TMS course of at least 36 sessions, with a sixth as many sessions (Hutton et al., 2024).⁴

Other Anhedonia Scales

On longer anhedonia scales, the 58% drop is higher than the 41% to 47% seen in studies of escitalopram and vortioxetine at eight weeks, and comparable to the 62% seen in a study of rTMS over about nine weeks (Dunlop et al., 2020; Cao et al., 2019; Fukuda et al., 2021).¹⁴⁻¹⁶

_{Mindbloom measured anhedonia with a single PHQ-9 question; comparator studies used multi-item anhedonia scales such as the SHAPS. Comparisons across different measures are directional.}

How Fast Does Ketamine Therapy Work for Anhedonia?

Change showed up early. By Session 2, about two weeks in, Mindbloom patients' anhedonia severity was already down 42% on average, and about 3 in 4 had improved (Carter et al., 2026).¹ That early drop is higher than the 16% seen with vortioxetine at week 2 (Cao et al., 2019).¹⁵ Improvement kept building, to 52% by Session 4 and 58% by Session 6.¹

Clinical research on IV ketamine also shows early change: in one placebo-controlled trial of people with treatment-resistant bipolar depression, a single ketamine infusion rapidly reduced anhedonia (Lally et al., 2014).¹⁹

How Ketamine May Work on Anhedonia: The Brain's Reward Circuit

Most antidepressants target serotonin. Researchers describe ketamine's effect as starting with changes in glutamate, the brain's main excitatory messenger, trigger growth signaling and neuroplasticity, the formation of new connections between brain cells, though the exact steps are still debated (Krystal et al., 2024).²⁰ For anhedonia, research on how ketamine helps depression centers on the brain's reward circuit, the system that makes things feel worth wanting and doing.

What Human Studies Show

• Reward and planning regions reconnecting. In a small placebo-controlled study of people with treatment-resistant depression, a single IV infusion strengthened communication between reward-related regions and the prefrontal cortex, which helps with planning and decisions, and people whose connection strengthened more saw their anhedonia improve more (Mkrtchian et al., 2021).⁸
• Anhedonia tracked separately in one trial. In the bipolar depression trial above, the drop in anhedonia after a single IV infusion did not depend on how much overall depressive symptoms improved (Lally et al., 2014).¹⁹

What Animal Studies Show

• Repairing reward connections. In stressed mice, a single dose of ketamine rebuilt weakened connections onto reward-circuit neurons in the nucleus accumbens, the brain's reward hub, and the mice regained their preference for sugar water (Lucantonio et al., 2025).⁷
• Why the repair matters. When the researchers blocked that repair, ketamine's lasting benefit disappeared, and when they strengthened the same connections artificially, the mice improved without ketamine.⁷

Connection repair itself has been shown directly only in animals; in people, the evidence comes from behavior and brain scans (Faisal et al., 2026).¹²

What Ketamine Therapy for Anhedonia Involves: Candidacy, Safety and Integration

Who May Be a Candidate

Ketamine therapy is prescribed for depression, so the starting point is a clinical assessment of your symptoms, history and medications. It may be worth raising with a clinician if loss of interest or pleasure is a major part of your depression, including if it has held on through other treatment or you have treatment-resistant depression.

Ketamine therapy is not right for everyone. Uncontrolled high blood pressure, a history of psychosis or mania, serious heart or breathing problems, and pregnancy are among the conditions that rule it out, and your clinician will check for medications that interact with ketamine.

Is Ketamine Therapy for Anhedonia Safe?

Ketamine therapy is generally well tolerated by people who pass medical screening. In the analysis behind this article, patients reported any side effect at 4.1% of post-session check-ins (Carter et al., 2026).¹ Mindbloom's peer-reviewed study of 11,441 patients taking sublingual ketamine at home found that no single side effect was reported by more than about 1% of patients at a check-in, and 0.4% stopped because of side effects (Mathai et al., 2024).²¹

• During sessions: a dreamlike or detached feeling, called dissociation, is an expected part of a session and passes as the session ends.
• Blood pressure: ketamine raises blood pressure temporarily, so it is checked around sessions.
• Misuse: ketamine can be misused, so at-home treatment involves medical screening and ongoing clinician oversight to manage addiction risk.

How Integration Supports Anhedonia Relief

Integration is the work between sessions of turning what shifted into everyday change, and with anhedonia that means gradually reconnecting with things you used to enjoy. Mindbloom's program pairs at-home sessions with guided integration programs and one-on-one coaching to help you prepare for each session and work through what comes up after it. Behavioral activation, a talk therapy built around gradually returning to rewarding activities, reduced anhedonia on its own in one trial (Cernasov et al., 2024),¹⁸ and the same idea applies between sessions:

• Start with one small, low-stakes activity you used to enjoy.
• Notice how it feels without judging whether it is enough.
• Add a little more as interest returns.

Conclusion

Ketamine therapy can help with anhedonia. Mindbloom's 2026 analysis found that patients who started with anhedonia most days saw its severity drop 58% on average by Session 6, and 89% improved by at least one point on the PHQ-9 anhedonia question (Carter et al., 2026).¹ On the same PHQ-9 question, those results were comparable to esketamine and TMS and higher than those reported for antidepressants, and the change was visible by Session 2. Research in animals and people points to the brain's reward circuit as one possible explanation for how ketamine affects anhedonia.