PTSD Augmented Psychotherapy With Ketamine (KPE) - First Results

Or Duek, Ifat Levy, Li Yutong, Charles Gordon, Benjamin Kelmendi, Ilan Harpaz-Rotem

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Background
Augmenting prolonged exposure (PE) with pharmacotherapy has been suggested as a promising solution to address treatment-resistant PTSD and high dropout rates. Ketamine has been shown to have rapid-acting effects on treatment resistant depression following single infusion and with neurogenesis, that may promote new learning. We present first results of ketamine augmentation of intensive 7-day-PE (KPE) for PTSD patients.
Methods
17 PTSD patients were randomized to Ketamine or Midazolam groups, after undergoing medical and clinical evaluation. The treatment protocol consisted of 7 daily sessions of PE with one-time 40min infusion of 0.5mg/kg ketamine or midazolam following the first exposure session inside an MRI. Before, after and follow-up treatment measurements included behavioral and fMRI data.
Results
PTSD symptoms scores were significantly reduced in both groups at 30-days follow-up [F(1,13)=7.47, pResting-state MRI before and after infusion indicated connectivity between caudate and parieto-occipital were significantly higher in the ketamine group [t(13)=5.74, pKetamine group showed higher global brain connectivity in tempo-occipital clusters at the end of treatment (7 days after first scan). A negative correlation between default mode network connectivity and PCL5 scores at follow up was found [r=-0.57, t(10)=-2.2, p=0.051)].
Conclusions
Augmenting PE with ketamine is a novel treatment. This study shows promising results in behavioral and neural measures, suggesting higher efficacy for KPE in long-term outcomes. The low number of patients requires us to use these results with caution, but evidence supporting changes in brain connectivity and no drop out propel further investigation.
Original languageAmerican English
Pages (from-to)S122-S122
JournalBiological Psychiatry
Volume85
Issue number10
DOIs
StatePublished - 15 May 2019
Externally publishedYes

Keywords

  • PTSD - Posttraumatic Stress Disorder
  • Ketamine
  • Prolonged Exposure
  • Clinical Trials

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