A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder

Feder, Adriana; Costi, Sara; Rutter, Sarah; Collins, Abigail; Govindarajulu, Usha; Jha, Manish K.; Horn, Sarah R.; Kautz, Marin; Corniquel, Morgan; Collins, Katherine A.; Bevilacqua, Laura; Glasgow, Andrew M; Brallier, Jess W.; Pietrzak, Robert H.; Murrough, James W.; Charney, Dennis S.

doi:10.1176/appi.ajp.2020.20050596

Cited by 149 publications

(171 citation statements)

References 36 publications

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“…Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line pharmacological treatment for PTSD, however response rates rarely exceed 60%, and less than 20% to 30% of patients achieve full remission (Berger et al, 2009). New research suggests that ketamine also has benefit for the treatment of PTSD (Feder et al, 2014(Feder et al, , 2021, although, there are fewer studies that examine ketamine-assisted psychotherapy (KAP) for this condition (Liriano et al, 2019). PTSD is a chronic and debilitating condition arising after exposure to a severe traumatic event, characterized by persistent reexperiencing, avoidance, and hyperarousal symptoms.…”

Section: Emphasis Of Ketaminementioning

confidence: 99%

Ketamine-Assisted Psychotherapy for PTSD Related to Racial Discrimination

Halstead¹,

Reed²,

Krause

et al. 2021

Clinical Case Studies

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Current research suggests that ketamine-assisted psychotherapy has benefit for the treatment of mental disorders. We report on the results of ketamine-assisted intensive outpatient psychotherapeutic treatment of a client with treatment-resistant, posttraumatic stress disorder (PTSD) as a result of experiences of racism and childhood sexual abuse. The client’s presenting symptoms included hypervigilance, social avoidance, feelings of hopelessness, and intense recollections. These symptoms impacted all areas of daily functioning. Psychoeducation was provided on how untreated intergenerational trauma, compounded by additional traumatic experiences, potentiated the client’s experience of PTSD and subsequent maladaptive coping mechanisms. Ketamine was administered four times over a 13-day span as an off-label, adjunct to psychotherapy. Therapeutic interventions and orientations utilized were mindfulness-based cognitive therapy (MBCT) and functional analytic psychotherapy (FAP). New skills were obtained in helping the client respond effectively to negative self-talk, catastrophic thinking, and feelings of helplessness. Treatment led to a significant reduction in symptoms after completion of the program, with gains maintained 4 months post-treatment. This case study demonstrates the effective use of ketamine as an adjunct to psychotherapy in treatment-resistant PTSD.

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Section: Emphasis Of Ketaminementioning

confidence: 99%

Ketamine-Assisted Psychotherapy for PTSD Related to Racial Discrimination

Halstead¹,

Reed²,

Krause

et al. 2021

Clinical Case Studies

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show abstract

“…Another open-label trial studied repeated iv ketamine infusions (0.5 mg/kg; six infusions over 12 days) and found rapid improvement in both PTSD and depressive symptoms, with the median time to relapse in PTSD remitters being 41 days [74]. Most recently, the first randomized controlled trial of repeated ketamine in PTSD found ketamine to elicit better improvement than the active control group receiving midazolam [75]. Overall, ketamine seems to hold promise in treating PTSD, but more studies are warranted.…”

Section: Psychiatric Usementioning

confidence: 99%

Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms

Kohtala

2021

Pharmacol. Rep

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Over the past 50 years, ketamine has solidified its position in both human and veterinary medicine as an important anesthetic with many uses. More recently, ketamine has been studied and used for several new indications, ranging from chronic pain to drug addiction and post-traumatic stress disorder. The discovery of the rapid-acting antidepressant effects of ketamine has resulted in a surge of interest towards understanding the precise mechanisms driving its effects. Indeed, ketamine may have had the largest impact for advancements in the research and treatment of psychiatric disorders in the past few decades. While intense research efforts have been aimed towards uncovering the molecular targets underlying ketamine’s effects in treating depression, the underlying neurobiological mechanisms remain elusive. These efforts are made more difficult by ketamine’s complex dose-dependent effects on molecular mechanisms, multiple pharmacologically active metabolites, and a mechanism of action associated with the facilitation of synaptic plasticity. This review aims to provide a brief overview of the different uses of ketamine, with an emphasis on examining ketamine’s rapid antidepressant effects spanning molecular, cellular, and network levels. Another focus of the review is to offer a perspective on studies related to the different doses of ketamine used in antidepressant research. Finally, the review discusses some of the latest hypotheses concerning ketamine’s action.

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“…New and effective treatments are needed for patients with PTSD. Feder et al (12) report findings from a randomized clinical trial examining the effects of repeated intravenous ketamine infusions on symptoms in PTSD patients. Ketamine is an N-methyl-D-aspartate receptor antagonist with effects on numerous other systems, including opiate receptors, and when administered in subanesthetic doses, it is effective in rapidly decreasing depressive symptoms.…”

Section: Ketamine Treatment For Ptsdmentioning

confidence: 99%

Trauma, Resilience, Anxiety Disorders, and PTSD

Kalin

2021

AJP

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A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder

Cited by 149 publications

References 36 publications

Ketamine-Assisted Psychotherapy for PTSD Related to Racial Discrimination

Ketamine-Assisted Psychotherapy for PTSD Related to Racial Discrimination

Ketamine—50 years in use: from anesthesia to rapid antidepressant effects and neurobiological mechanisms

Trauma, Resilience, Anxiety Disorders, and PTSD

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