A case series of group-based ketamine-assisted psychotherapy for patients in residential treatment for eating disorders with comorbid depression and anxiety disorders

Abstract

Background Depression and anxiety outcome measures, safety/tolerability, patient satisfaction, and ease of implementation of group-based ketamine-assisted psychotherapy (G-KAP) delivered to patients in intensive residential eating disorder (ED) treatment were assessed. Case presentation This study reports on five participants with a diagnosis of an ED and comorbid mood and anxiety disorders who received weekly intramuscular ketamine injections in a group setting over 4 weeks. Measures of anxiety (GAD-7) and depression (PHQ-9) were administered pre-dose, 4-h post-dose, and 24-h post dose. Four of the 5 participants experienced clinically significant improvements on the PHQ-9 score (i.e., change greater than 5) while 2 of the 5 participants experienced clinically significant improvements on the GAD-7 score (i.e., change greater than 4) from pre-dose to 24-h post-dose after the last ketamine session. Dosing sessions were well tolerated, and no serious adverse events were reported. Clinical observations and participant reports corroborated improvements in depression and anxiety symptoms, good tolerability of ketamine treatment, and practical implementation of the G-KAP protocol in a residential ED treatment center. Conclusions This study suggests the potential utility of G-KAP as an adjunct to intensive, specialized ED treatment. Overall, this novel, cross-diagnostic intervention warrants future research to further explore its appropriateness in a treatment setting.

Non-linear association between Mediterranean diet and depressive symptom in U.S. adults: A cross-sectional study

“…Third, due to missing data, some psychiatric comorbidities were not considered as covariates in our analyses. For example, eating disorders and attention deficit hyperactivity disorder were not considered in this study (46,47). Moreover, the state of mental health cannot be ruled out in regard to exerting a significant influence on the association between aMED score and depression as cognitive function and prescription medications were not assessed in this study.…”

Ketamine and psychotherapy for the treatment of psychiatric disorders: systematic review

“…The remaining four studies were single-arm studies that evaluated patients with eating disorders and comorbid generalised anxiety and depression symptoms, 42 obsessive-compulsive disorder (OCD) 26 and mixed diagnostic samples. 43,44 Dore et al 44 retrospectively analysed data from patients (n = 235) who had received ketamine and psychotherapy across three private psychiatric practices.…”

“…ketamine injections. [30][31][32][42][43][44] . Treatment doses started at 25 mg in the ED population 42 and were typically in the 1-2 mg/kg range.…”

“…[30][31][32][42][43][44] . Treatment doses started at 25 mg in the ED population 42 and were typically in the 1-2 mg/kg range. Dosing frequency ranged from single ketamine dose protocols 32 to the case series reported by Dore et al 44 with up to 25 ketamine treatment sessions.…”

“…Nine studies involved the delivery of psychotherapy at the time of ketamine dosing (when participants were acutely affected by ketamine. [30][31][32]38,39,[41][42][43][44] One study (Grabski et al 23 ) delivered ketamine and psychotherapy concurrently, whereby therapy sessions were timed so that they preceded ketamine administration in addition to occurring approximately 24 h later.…”