One key component that seems to be missing from a lot of the excitement about these treatments is how important an ongoing therapy or other behavioural support component usually is. A lot of patients find some relief from a ketamine or other therapy but it can open up a host of issues they have not dealt with or it can resurface old behaviours.
One example was a patient who had a long history of abuse which was more or less hidden by their severe depression and suicidal tendencies. They had a series of ketamine treatments by an anesthesiologist and it cracked that past right open. The place they were taking the treatment was not equipped to support that and they did not have immediate access to psychiatric or even good psychological support and it did create a bit of a spiral.
I don't think any of that comes as a surprised to people in the field, but each patient and circumstance is different. The sooner we can bring these treatments in to mainstream health research, the more holistic the approach to patient health can be.
Lots of interesting stuff to learn. I am just bystander-fascinated by it and am not professing any expertise here.