Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study

Abstract

Trauma exposure across the lifespan produces risks for posttraumatic stress disorder (PTSD), depression, anxiety, as well as global disability in functioning. This retrospective clinical chart review is the first of its kind to assess the utility of sublingual ketamine-assisted body-centered psychotherapy in trauma-exposed patients in a real world clinic setting. De-identified clinical records data on self-reported symptom measures were retrospectively analyzed for patients (N = 18; M age = 45.22, SD = 12.90) entering ketamine-assisted psychotherapy treatment in an outpatient clinic between 2018 and 2020. Patients who completed six sessions of ketamine therapy reported meaningful (e.g., medium effect size) improvements in PTSD symptoms (P = 0.058; d = −0.48) and global disability in functioning (P = 0.050; d = −0.52) and statistically significant and meaningful improvements in depression (P = 0.019; d = −0.53). There were no improvements in anxiety symptoms. Sublingual ketamine-assisted psychotherapy was associated with heterogenous clinical utility among patients with trauma-exposure in an outpatient setting. This study was underpowered and unrepresentative of the population of ketamine patients in the United States. Replication of these findings is needed with larger and more diverse patient samples.

The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence

“…Taking a step further, Davis et al 76 examined KAP in trauma-exposed individuals, leveraging sublingual administration and body-centered techniques. As part of standard care, patients ( N = 18, M age = 45.2, female = 56%) underwent six sessions of ketamine (100–200 mg) combined with somatic-based interactional psychotherapy, each 120 min.…”

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

“…Discussing patients’ motives, intentions, and expectations for treatment, evaluating their current psychophysiological status, and providing a therapeutic environment conducive to the ketamine experience (i.e., “set and setting”) are essential factors to consider prior to treatment. Examining different psychotherapeutic approaches in this context is also recommended, which has progressively diversified over the years to include cognitive–behavioral [ 165 ], humanistic [ 140 , 166 ], functional–analytic [ 167 ], and somatic-based interactional [ 168 ] therapy.…”

Ketamine as a Novel Psychopharmacotherapy for Eating Disorders: Evidence and Future Directions

“…Discussing patients' motives, intentions, and expectations for treatment, evaluating their current psychophysiological status, and providing a therapeutic environment conducive to the ketamine experience (i.e., "set and setting") are essential factors to consider prior to treatment. Examining different psychotherapeutic approaches in this context is additionally recommended, which has progressively diversified over the years to include cognitive-behavioral [147], humanistic [121,148], functional-analytic [149], and somatic-based interactional [150] therapy.…”