What is functional neurological disorder?

Functional neurological disorder, or FND, is a condition in which the nervous system's structure is intact but its function is disrupted, producing real neurological symptoms such as tremor, limb weakness, difficulty walking, sensory changes, or seizure-like episodes. The symptoms are genuine and involuntary, not imagined or faked. Doctors sometimes describe it as a problem with the brain's 'software' rather than its 'hardware.' It's one of the most common reasons people are referred to neurology clinics, with prevalence estimates in the range of roughly 80 to 140 per 100,000 people, and diagnosis is rising as awareness improves.

Is ketamine a proven treatment for FND?

No. The first-line, evidence-based treatments for FND are a clear and empathic diagnosis, symptom-focused physical or occupational therapy, and psychotherapy such as CBT. Ketamine is not an established FND treatment. The evidence that exists is limited to case reports and small case series—for example, reports of subdissociative ketamine used in emergency settings for functional symptoms, and a case of functional seizures improving with ketamine-assisted therapy. These are promising signals, not proof, and we're careful not to present ketamine as an FND cure.

Are functional seizures the same as epilepsy?

No. Functional seizures—also called psychogenic non-epileptic seizures or PNES—look like epileptic seizures but do not arise from the abnormal electrical activity that defines epilepsy. This distinction matters because treating functional seizures with anti-epileptic drugs generally doesn't work and can sometimes cause harm. Accurate diagnosis, usually with video EEG, is essential, and the effective treatments are psychological rather than anti-seizure medications.

Why might ketamine even be considered for FND?

Two reasons. First, FND very frequently coexists with depression, anxiety, PTSD, and a high burden of past adverse life events—conditions ketamine does have evidence for. Treating that co-occurring load can meaningfully improve a person's overall picture. Second, ketamine's effects on neuroplasticity and NMDA-receptor signaling have led researchers to theorize it might influence some of the brain-network dysfunction thought to underlie FND itself. The second idea is still theoretical, while the first is where any real, current value most likely lies.

I have FND and also struggle with depression—can you help?

We'd want to be thoughtful and honest with you. We don't offer ketamine as a treatment for FND itself, and we'd always encourage staying connected with a neurologist and an FND-informed therapist. But if you're also dealing with treatment-resistant depression, anxiety, or PTSD alongside your FND, that co-occurring condition may be something ketamine can help with. The right first step is a consultation where we can understand your full situation, coordinate rather than compete with your existing care, and give you a clear, honest read.

Ketamine and Functional Neurological Disorder

Few diagnoses are as misunderstood as functional neurological disorder. People who have it are often told, in one way or another, that their symptoms aren’t real—that the tremor, the leg that won’t hold weight, the episodes that look like seizures are “all in their head.” That framing is both wrong and harmful. FND is a genuine neurological condition, and the people living with it deserve accurate information rather than dismissal.

Because ketamine has been in the news for so many hard-to-treat brain conditions, some people with FND naturally wonder whether it might help them too. We want to answer that question carefully and honestly, because this is an area where hype could easily lead someone astray. The short version is that ketamine is not an established treatment for FND itself—but there’s a real and different way it can matter for many people who carry this diagnosis.

What FND Actually Is

Functional neurological disorder describes a set of neurological symptoms that arise from a problem in how the brain functions rather than a problem in its physical structure. A useful analogy that clinicians often use: the hardware is intact, but the software has a glitch. Brain scans typically look normal, yet the symptoms are entirely real and outside the person’s voluntary control.

Those symptoms can take many forms:

Functional weakness or paralysis in a limb
Tremor, jerking, or other abnormal movements
Difficulty walking or problems with balance
Sensory changes, numbness, or vision disturbance
Functional (non-epileptic) seizures
Cognitive symptoms like brain fog and word-finding trouble

This is not a rare, exotic problem. FND is among the most common reasons people are referred to a neurologist, with prevalence estimates in the neighborhood of 80 to 140 per 100,000 people. Diagnoses appear to be rising, partly because clinicians are getting better at recognizing it and partly because the psychosocial stressors that raise risk are increasingly common.

The Point About Functional Seizures

One of the most important—and most frequently botched—areas within FND is functional seizures, also called psychogenic non-epileptic seizures, or PNES. These episodes can look strikingly like epileptic seizures, but they don’t come from the abnormal electrical discharges that define epilepsy.

That distinction isn’t academic. Treating functional seizures as if they were epilepsy—with escalating anti-seizure drugs—generally doesn’t work and can sometimes make things worse. Getting the diagnosis right, often with video EEG, spares people from years of ineffective medication and points them toward treatments that actually help. That’s worth stating plainly, because a lot of harm in this space comes from misdiagnosis rather than from the condition itself.

What Actually Treats FND

The first-line, evidence-based approach to FND doesn’t start with a drug. It starts with a clear, compassionate explanation of the diagnosis—which is itself therapeutic, because understanding that the symptoms are real, recognized, and potentially reversible changes the whole trajectory. From there, care is built around:

Symptom-focused rehabilitation—specialist physical and occupational therapy that retrains movement and redirects attention
Psychotherapy—cognitive behavioral therapy and related approaches, which have the strongest evidence, especially for functional seizures
Treatment of co-occurring conditions—the depression, anxiety, and PTSD that frequently accompany FND

The outcomes are honest but hopeful: current evidence suggests these treatments produce modest but meaningful benefit for a substantial share of patients, while some continue to struggle despite good care. This is a condition that rewards patience, the right team, and realistic expectations.

Individualized psychotherapy work reveals a very high prevalence of adverse life events in functional neurological disorders—an important clue to why treating the co-occurring psychological burden matters so much. — Reflected in recent FND psychotherapy research, National Library of Medicine, PMC

So Where Could Ketamine Possibly Fit?

Here’s the honest map. There are two very different reasons ketamine comes up, and it’s worth keeping them separate.

The theoretical reason. A handful of case reports have described ketamine being used in the context of functional symptoms—for example, subdissociative ketamine given in an emergency department for a functional presentation, and a published case of refractory functional seizures and depression improving with ketamine-assisted therapy. Researchers have speculated that ketamine’s action on NMDA receptors and its effects on brain-network activity might, in theory, touch some of the mechanisms thought to drive FND. But this is genuinely early—single cases and small series, not controlled trials. It would be irresponsible to present it as anything more than a research signal, and we don’t.

The practical reason. This is where any real, present-day value most likely sits. FND rarely travels alone. It coexists at high rates with depression, anxiety, PTSD, and a heavy history of adverse life events. Those co-occurring conditions are exactly the territory where ketamine has actual evidence. If someone with FND is also carrying treatment-resistant depression or PTSD, addressing that load can improve their quality of life and, sometimes, their overall symptom picture—even if the ketamine isn’t treating the functional symptoms directly.

In other words: we wouldn’t offer ketamine to treat a functional tremor. But we might have a serious conversation about ketamine for the disabling depression sitting alongside that tremor, while the FND itself is managed by the appropriate neurological and rehabilitative care.

A Word of Caution About Dissociation

There’s a specific reason to be thoughtful here. Ketamine produces temporary dissociation as part of its effect, and dissociative experiences overlap conceptually with some of the mechanisms discussed in FND and functional seizures. For most people this is a non-issue, but it’s exactly the kind of consideration that calls for individualized judgment rather than a blanket yes or no. Anyone with a significant history of dissociative symptoms deserves a careful, unhurried evaluation before starting, and we’d always want to be coordinating with their existing clinicians.

How We’d Handle This

If you have FND and you’re wondering about ketamine, the most useful thing we can offer is straight talk. We don’t treat FND with ketamine, and we’d encourage you to stay connected with a neurologist and, ideally, an FND-informed therapist. Our related writing on finding an integration therapist in Tennessee may help on that front.

Where we can genuinely help is if a co-occurring condition—treatment-resistant depression, severe anxiety, or PTSD—is part of your picture. In that case, a consultation lets us understand the whole situation, coordinate rather than compete with your existing care, and be clear about what ketamine can and can’t reasonably be expected to do.

The Bottom Line

FND is real, common, and too often mishandled. Its established treatments are a clear diagnosis, targeted rehabilitation, and psychotherapy—not ketamine. The ketamine-for-FND evidence remains at the case-report stage and shouldn’t be oversold. What we can stand behind is ketamine’s role in the depression, anxiety, and PTSD that so frequently accompany FND, handled with care and in coordination with the rest of your team.

If that describes your situation, we’d be glad to talk—honestly, without pressure, and with respect for how much misinformation you’ve probably already had to sort through.

Ketamine and Functional Neurological Disorder (FND)