While ketamine was originally developed for anesthesia, this section will focus on the indications that ketamine-assisted therapy typically treats.
Ketamine has been shown to have beneficial effects for a range of mental health conditions which will be discussed in greater detail below.
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For clients with treatment-resistant anxiety, Glue et al. (2018) noted that they remained in remission three months after completing several doses of ketamine with a small portion of patients experiencing a partial or full relapse of symptoms (Rush et al., 2022).
Although thought to help with both unipolar and bipolar depressive episodes, some research has suggested greater effect as well as longer-lasting benefits for unipolar than bipolar depressive symptoms (Kishimoto et al., 2016; Lee et al., 2015; McGirr et al., 2015).
One retrospective analysis, for example, found that ketamine treatment for depression produced a response in about 50% of participants, while 30% met criteria for remission (McInnes et al., 2022); another study saw a response in 71% of participants with 29% achieving remission from treatment-resistant depression (Zarate et al., 2006). One study involving 235 participants displayed drastic drops in depression and anxiety after ketamine-assisted therapy, reflected in scores on the Beck Depression Inventory and the Hamilton Anxiety Scale; the improvement indicated in this study was found to be strongest among those with developmental trauma, as well as those who presented with more severe depression and anxiety symptoms at intake (Dore et al., 2019).
In a study in 2022, Calabrese et al. conducted a trial with 5 adults whose weights recovered from anorexia nervosa but still had eating disorder behaviours. The participants consumed a ketogenic diet for at least 4 weeks and then received 6 ketamine doses over the span of 6 months. The participants showed significant improvements across all eating disorder metrics used in the study. Only one participant relapsed 4 months after the study.
In the first randomized trial, Rodriguez et al. (2013) investigated the degree to which ketamine can be used as a treatment for obsessive-compulsive disorder. 50% of those in the trial met the criteria for treatment response, however further studies are needed.
For PTS, in one randomized controlled study, ketamine was administered intravenously and compared with intravenous midazolam; significant improvement occurred in 67% of the ketamine group while only 20% in the midazolam group saw such results (Feder et al., 2021). In a study of individuals suffering from PTSD related to racial discrimination, ketamine-assisted therapy was shown to help participants develop new skills to handle negative self-talk, catastrophic thinking, and feelings of helplessness; it also led to a significant reduction in symptoms which were maintained at follow up 4 months after the study (Halstead et al., 2021).
Ketamine has also been shown to help with addictions by improving cravings and motivation to quit using, as well as improving abstinence rates for many substance addictions (Walsh et al., 2021). It has also been shown to significantly change relationships with alcohol among research participants with alcohol use disorder (Mollaahmetoglu et al., 2021). One study of 96 participants with alcohol use disorder, for example, demonstrated that ketamine combined with relapse prevention–based therapy led to significantly more days abstained from alcohol use at 6-month follow-up than was seen with placebo (Grabski et al., 2022).
Indeed, its antidepressant effects are well known and have been consistently displayed in research, with noticeable improvement usually being seen within hours of administration of the medicine. It may also serve to diminish the risk of suicide (Fond et al., 2014; Hasler, 2020; Kishimoto et al., 2016; Krystal, 2007; Lee et al., 2015; Marcantoni et al., 2020; McGirr et al., 2015; Romeo et al., 2015).
Select one of the key studies above. Read through the study and summarize the main points in this document. The password for the document is ketamine.
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Azhari, N., Hu, H., O'Malley, K. Y., Blocker, M. E., Levin, F. R., & Dakwar, E. (2021). Ketamine-facilitated behavioral treatment for cannabis use disorder: A proof of concept study. Am J Drug Alcohol Abuse, 47(1), 92-97. https://doi.org/10.1080/00952990.2020.1808982
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Bennett, R., Yavorsky, C. & Bravo, G. (2022). Ketamine for bipolar depression: biochemical, psychotherapeutic, and psychedelic approaches. Frontiers in Psychiatry, 13. DOI: 10.3389/fpsyt.2022.867484
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Bottemanne, H., & Arnould, A. (2021). Ketamine augmentation of exposure response prevention therapy for obsessive-compulsive disorder. Innovations in clinical neuroscience, 18(10-12), 9–11.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794478/
Caddy, C., Amit, B. H., McCloud, T. L., Rendell, J. M., Furukawa, T. A., McShane, R., . . . Cipriani, A. (2015). Ketamine and other glutamate receptor modulators for depression in adults. Cochrane Database Syst Rev(9), CD011612. https://doi.org/10.1002/14651858.cd011612.pub2
Caddy, C., Giaroli, G., White, T. P., Shergill, S. S., & Tracy, D. K. (2014). Ketamine as the prototype glutamatergic antidepressant: pharmacodynamic actions, and a systematic review and meta-analysis of efficacy. Ther Adv Psychopharmacol, 4(2), 75-99. https://doi.org/10.1177/2045125313507739
Calabrese, L., Scolnick, B., Zupec-Kania, B., Beckwith, C., Costello, K. & Guido, F. (2022). Ketogenic diet and ketamine infusion treatment to target chronic persistent eating disorder psychopathology in anorexia nervosa: a pilot study. Eating and Weight Disorders. DOI: 10.1007/s40519-022-01455
https://doi.org/10.1007/s40519-022-01455-x
Calabrese, L. (2019). Titrated serial ketamine infusions stop outpatient suicidality and avert ER Visits and hospitalizations. International Journal of Psychiatry Research, 2(6), 1-12.
http://scivisionpub.com/pdfs/titrated-serial-ketamine-infusions-stop-outpatient-suicidality-and-avert-er-visits-and-hospitalizations-918.pdf
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Dadiomov, D., & Lee, K. (2019). The effects of ketamine on suicidality across various formulations and study settings. Ment Health Clin, 9(1), 48-60. https://doi.org/10.9740%2Fmhc.2019.01.048
Azhari et al., 2021; Dakwar, Anerella, et al., 2014; Dakwar et al., 2017; Dakwar, Levin, et al., 2014; Dakwar et al., 2020; Dakwar et al., 2019; Dakwar et al., 2018; Jones et al., 2018; Jovaisa et al., 2006; Krupitsky et al., 2002; Krupitsky et al., 2007; Krupitsky et al., 1992; Krupitsky & Grinenko, 1997; Lalanne et al., 2016; Pizon et al., 2018; Rothberg et al., 2021; Rothberg et al., 2020; Shah et al., 2018;
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Dakwar, E., Hart, C. L., Levin, F. R., Nunes, E. V., & Foltin, R. W. (2017). Cocaine self-administration disrupted by the N-methyl-D-aspartate receptor antagonist ketamine: a randomized, crossover trial. Mol Psychiatry, 22(1), 76-81. https://doi.org/10.1038/mp.2016.39
Dakwar, E., Levin, F., Foltin, R. W., Nunes, E. V., & Hart, C. L. (2014). The effects of subanesthetic ketamine infusions on motivation to quit and cue-induced craving in cocaine-dependent research volunteers. Biol Psychiatry, 76(1), 40-46. https://doi.org/10.1016/j.biopsych.2013.08.009
Dakwar, E., Levin, F., Hart, C. L., Basaraba, C., Choi, J., Pavlicova, M., & Nunes, E. V. (2020). A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. Am J Psychiatry, 177(2), 125-133. https://doi.org/10.1176/appi.ajp.2019.19070684
Dakwar, E., Nunes, E. V., Hart, C. L., Foltin, R. W., Mathew, S. J., Carpenter, K. M., . . . Levin, F. R. (2019). A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. Am J Psychiatry, 176(11), 923-930. https://doi.org/10.1176/appi.ajp.2019.18101123
Dakwar, E., Nunes, E. V., Hart, C. L., Hu, M. C., Foltin, R. W., & Levin, F. R. (2018). A sub-set of psychoactive effects may be critical to the behavioral impact of ketamine on cocaine use disorder: Results from a randomized, controlled laboratory study. Neuropharmacology, 142, 270-276. https://doi.org/10.1016/j.neuropharm.2018.01.005
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Halstead, M., Reed, S., Krause, R. & Williams, M. (2021). Ketamine-assisted psychotherapy for PTSD related to racial discrimination. Clinical Case Studies, 20(4), 310-330. DOI: 10.1177/1534650121990894
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