Functional Neurological Disorder (FND)

Tovani does not treat this with ketamine

This page is here for honesty and completeness. Ketamine is not an appropriate treatment for Functional Neurological Disorder, and in some cases it is contraindicated. Below is what the condition is and the treatments that genuinely help — and where, if at all, ketamine has any narrow role (usually only for a separate co-occurring depression). If you’re in crisis, call or text 988.

The short version

●FND (formerly conversion disorder) produces genuine neurological symptoms — limb weakness, functional (non-epileptic) seizures, tremor, gait or sensory problems — not explained by structural disease.
●The symptoms are real and involuntary, not "faked"; they arise from a problem in how the nervous system functions, and are diagnosed by positive clinical signs, not just by ruling things out.
●It commonly follows stress, illness, injury, or trauma, but not always — and a "normal" MRI does not mean the symptoms are not real.
●Treatment is multidisciplinary and FND-specific: education, physiotherapy for functional motor symptoms, and psychological therapy (especially for functional seizures).¹ ²
●There is no medication that treats FND itself; treatment targets the functional symptoms and any co-occurring depression/anxiety.
●Ketamine is not an FND treatment; the evidence-based care is the FND-informed team approach.

Clinical definition

FND is characterized by neurological symptoms — altered voluntary motor or sensory function, including weakness, abnormal movements, gait disorder, sensory loss, or non-epileptic (functional/dissociative) seizures — that are incompatible with recognized neurological disease, demonstrated by positive examination signs (e.g., Hoover's sign, tremor entrainment, specific seizure semiology). DSM-5 no longer requires an identifiable psychological stressor or proof that symptoms are not feigned. It reflects a disorder of nervous-system functioning — of how the brain processes movement, sensation, and attention — and sits at the intersection of neurology and psychiatry, best understood within a biopsychosocial model.

How it differs from related conditions

vs. Somatic symptom disorder

SSD centers on distressing bodily symptoms and excessive health-related thoughts/behaviors; FND specifically involves neurological dysfunction shown by positive signs.

vs. Dissociative identity disorder

Functional seizures are sometimes called dissociative seizures; FND shares dissociative mechanisms but presents as neurological symptoms.

vs. Major depressive disorder

Depression and anxiety frequently co-occur with and can amplify FND, and are treated alongside it.

First-line treatments

Clear, validating diagnosis + education

Explaining FND as a real, common, and potentially reversible problem is itself therapeutic and the foundation of care.

FND-specialized physiotherapy

For functional motor symptoms (weakness, gait, tremor), retraining normal movement.

Psychological therapy (CBT)

Especially effective for functional/non-epileptic seizures; addresses symptom triggers and co-occurring distress.

Multidisciplinary, coordinated care

Neurology, physiotherapy, psychology, and sometimes speech/occupational therapy working together.

When standard treatments fail

When FND is persistent, care intensifies the multidisciplinary, FND-specific approach — specialist inpatient or intensive outpatient rehabilitation, refining physiotherapy and psychological therapy, and treating co-occurring depression, anxiety, or pain. The pathway does not include rapid-acting psychiatric agents like ketamine, which have no role in FND.

Where ketamine fits

Ketamine is not a treatment for functional neurological disorder. FND is managed through a specific, multidisciplinary approach — a clear and validating diagnosis, FND-informed physiotherapy for motor symptoms, and psychological therapy (notably CBT for functional seizures) — supported by current neurology and psychiatry frameworks.¹ ² There is no evidence base for ketamine in FND, and its dissociative effects are not therapeutic for a disorder in which dissociation and altered nervous-system functioning are part of the mechanism. Where depression or anxiety co-occur, those can be treated on their own terms, but the functional neurological symptoms require FND-specific care, not ketamine.

Where this fits with Tovani

Tovani treats mood, anxiety, PTSD, and certain pain conditions — not FND, which needs a coordinated, FND-informed neurology-and-rehabilitation team. The most important first step in FND is often a clear, validating diagnosis and the right physiotherapy and psychological therapy. If depression or anxiety co-occur with your FND, we may be able to help with those, but the functional neurological symptoms themselves belong with an FND-experienced team. This page is here to point you toward that care.

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Frequently asked

Can ketamine treat functional neurological disorder?

No. FND is treated with a multidisciplinary, FND-specific approach — a clear diagnosis, specialized physiotherapy, and psychological therapy (especially CBT for functional seizures). There is no evidence for ketamine in FND, and its dissociative effects are not therapeutic here.

Are FND symptoms real or "in my head"?

They are real and involuntary — not faked. FND is a problem in how the nervous system functions, diagnosed by positive examination signs, not just by a normal scan. A normal MRI does not mean the symptoms are not genuine.

What actually helps FND?

Starting with a clear, validating diagnosis, then FND-informed physiotherapy for movement symptoms and psychological therapy (CBT has strong evidence for functional seizures), delivered by a coordinated team. Many people improve, especially with early, FND-specific care.

Does Tovani treat FND?

No — it needs an FND-experienced neurology-and-rehabilitation team. We can potentially help with co-occurring depression or anxiety, but the functional neurological symptoms require FND-specific care. We would point you there.

References

Espay AJ et al. 2018, JAMA Neurology — Current concepts in the diagnosis and treatment of functional neurological disorders. (PMID 29868890)
Aybek S & Perez DL 2022, BMJ — Diagnosis and management of functional neurological disorder. (PMID 35074803)

Last reviewed by Dr. Ben Soffer, DO on June 2, 2026. This page is educational and not a substitute for clinical evaluation. A physician determines whether ketamine therapy is appropriate for your specific situation.