Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER) psychotherapy prolong the therapeutic effects of single ketamine infusion on post-traumatic stress disorder and comorbid depression: a pilot randomized, placebo-controlled, crossover clinical trial

Pradhan, Basant; Wainer, Irving W.; Moaddel, Ruin; Torjman, Marc C.; Goldberg, Michael A.; Sabia, Michael; Parikh, Tapan; Pumariega, Andrés J.

doi:10.4103/2542-3932.211589

Cited by 36 publications

(90 citation statements)

References 36 publications

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“…Pradhan et al 25 compared ketamine 0.5 mg/kg IV infusion to normal saline infusion in the context of Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER) psychotherapy in 10 patients with chronic PTSD. This was a modified crossover design; participants were switched from placebo to ketamine after a sustained relapse.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders

Whittaker

Dadabayev

Joshi

et al. 2021

Therapeutic Advances in Psychopharmacology

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Background: Anxiety disorders are common, associated with significant burden of disease, and have high levels of treatment resistance. Low-dose ketamine has been extensively studied in treatment-resistant depression, with fewer reports in treatment-resistant anxiety disorders. Aims: This systematic review and meta-analysis collected efficacy, safety, and tolerability data for ketamine as a treatment for anxiety spectrum disorders. Methods: We conducted a systematic search for randomized controlled trials (RCTs) of acute ketamine treatment for patients with anxiety disorders. Open-label trials of ketamine maintenance therapy were also considered. Qualitative and, where possible, quantitative syntheses of findings were performed using Review Manager software (RevMan). Acute dose-response and maintenance treatment data were also collected. Results: There were six eligible acute RCTs – two in social anxiety disorder (SAD), three in post-traumatic stress disorder (PTSD), and one in obsessive-compulsive disorder (OCD). Four of the six showed significant improvement in anxiety rating scores in ketamine compared with control groups. Pooled analysis showed ketamine was associated with an increased likelihood of treatment response for SAD (odds ratio (OR): 28.94; 95% confidence interval [CI]: 3.45–242.57; p = 0.002) but not for PTSD (OR: 2.03; 95% CI: 0.67–6.15; p = 0.21). A dose-response profile was observed for ketamine and changes in SAD symptoms, with doses ⩾0.5 mg/kg associated with greater reduction in anxiety rating scores than lower doses. Ketamine maintenance therapy was associated with sustained anxiolytic effects and improved social and/or work functioning. Conclusion: These preliminary analyses suggest that acute ketamine may be broadly effective across treatment-resistant anxiety spectrum disorders. These effects can be prolonged with maintenance treatment. Future studies will be needed to provide critical knowledge gaps around off-label use, side effects, and potential risks for abuse in clinical settings.

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Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders

Whittaker

Dadabayev

Joshi

et al. 2021

Therapeutic Advances in Psychopharmacology

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“…The rapid action of esketamine highlights the delayed therapeutic onset seen with SSRIs and other available pharmacotherapies. (R,S)ketamine, as an adjunct to psychotherapy, has also been investigated for the treatment of PTSD, with encouraging preliminary results (Pradhan et al, 2017(Pradhan et al, , 2018.…”

Section: Novel Treatment Approachesmentioning

confidence: 99%

Psilocybin and MDMA for the treatment of trauma-related psychopathology

Bird

Modlin

Rucker

2021

International Review of Psychiatry

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This review examines the role of trauma in psychiatric morbidity and analogous psychoneurobiological changes. Trauma is a necessary criterion for Post-Traumatic Stress Disorder (PTSD), however, trauma history is highly correlated with a variety of psychiatric conditions. Some evidence suggests that Major Depressive Disorder (MDD) is the most common psychiatric condition that arises following trauma. Approximately 50% of PTSD cases present with co-morbid MDD. Overlapping symptomatology and neurobiology between these conditions underlie the debate over whether these phenomena result from problematic nosology or whether comorbid MDD þ PTSD is a distinct phenotype of trauma-related psychopathology. Regardless, similar treatment approaches have been employed historically, with varying success. The drug-assisted psychotherapy treatment model, which combines pharmacological and psychotherapeutic approaches, is currently being trialled as a novel treatment approach in psychiatry. Both psilocybin-and 3,4-Methylenedioxymethamphetamine (MDMA)-assisted psychotherapy have received Food and Drug Administration 'breakthrough therapy' designation for the treatment of resistant MDD and PTSD, respectively. This paper reviews the therapeutic rationale of both psilocybin and MDMA for treating both trauma-related MDD and PTSD.

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“…Patients in 5 studies (Table 1) [43-46,48] received diagnosis of PTSD assessed with a score of PTSD Checklist (PCL) [51]. Patients in 4 studies (Table 1) [27,28,46,48] received the Clinician-Administered PTSD Scale (CAPS) [52]. Patients in 4 studies (Table 1) [27,28,47,49] received Impact of Event Scale-Revised (IES-R) [53].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies [47,48,50] including 67 patients (ketamine 29, control 38) reported scores changed in short duration of PTSD (months) by scales of ASDS (four subscales, including dissociation, reexperiencing, avoidance and hyperarousal) [50], IES-R, PCL and CAPS (Fig. 4).…”

Section: Resultsmentioning

confidence: 99%

Ketamine for the multivariate effect of PTSD: Systematic review and meta-analysis

Lü

et al. 2021

Preprint

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The aim of this systematic review and meta-analysis was to examine the efficacy, anti-effect of ketamine (intervention) for post-traumatic stress disorder (PTSD) patients during analgesia proceeding and mental illness treatment methods, in comparison with control (midazolam, opioid, saline or placebo). The bibliographic databases Cochrane, Embase, Pubmed and Web of Science were searched from inception to 23 May 2021 for randomized controlled trials, case-control and cohort studies included. For continuous and dichotomous outcomes, respectively, we calculated the mean difference using the inverse-variance method and the risk ratio with the Mantel-Haenszel method. In all, ten trials with 705 patients were included. Confirmed by meta-analysis, ketamine didn't increase the prevalence of PTSD by a risk ratio (95 % CI) of 0.86 (0.61 to 1.20), p = 0.38 in 3 trials with 503 patients. Evidence of a difference was found in the PTSD-scales taken between ketamine and control during short durations (months), with a mean difference (95 % CI) of 2.45 (1.33 to 3.58), p < 0.001 in three trials with 65 patients. Another evidence is shown in chronic PTSD (years), with a mean difference (95 % CI) of -3.66 (-7.05 to -0.27), p = 0.03 in three trials with 91 patients. Sub-group analysis underlined the increased benefit of ketamine administration for those in whom the procedure was more than one week in the chronic PTSD group. The adoption of ketamine for the short duration of PTSD is in avoidance, but for chronic PTSD is recommended and, in the opinion of the authors, should be considered as a new therapy in view of its potential to ameliorate arousal, avoidance and dissociative symptoms, neuroticism after trauma needing more animal research and clinical trials.

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Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER) psychotherapy prolong the therapeutic effects of single ketamine infusion on post-traumatic stress disorder and comorbid depression: a pilot randomized, placebo-controlled, crossover clinical trial

Cited by 36 publications

References 36 publications

Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders

Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders

Psilocybin and MDMA for the treatment of trauma-related psychopathology

Ketamine for the multivariate effect of PTSD: Systematic review and meta-analysis

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