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Combining Ketamine Infusions and Written Exposure Therapy for Chronic PTSD: An Open-Label Trial.

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This study shows that combining ketamine infusions with written exposure therapy (WET) significantly reduces chronic posttraumatic stress disorder (PTSD) symptoms. The combined treatment offers rapid and durable relief for severe PTSD.

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Area of Science:

  • Psychiatry and Clinical Psychology
  • Neuroscience
  • Pharmacology

Background:

  • Chronic posttraumatic stress disorder (PTSD) poses a significant challenge, often requiring novel therapeutic approaches.
  • Existing treatments for severe PTSD may have limitations in efficacy and durability.
  • Ketamine and exposure-based therapies show promise individually for PTSD treatment.

Purpose of the Study:

  • To evaluate the preliminary efficacy of combining ketamine infusions with written exposure therapy (WET) for chronic PTSD.
  • To assess symptom severity changes using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5).
  • To determine treatment response rates and durability of effects.

Main Methods:

  • An open-label clinical trial involving patients with chronic PTSD and moderate-to-severe symptoms.
  • Participants received 6 intravenous ketamine infusions over 2 weeks alongside 5 WET sessions.
  • Outcomes were measured by changes in CAPS-5 scores from baseline to 12 weeks post-treatment.

Main Results:

  • The combined ketamine and WET treatment led to a large-magnitude reduction in PTSD symptom severity (Cohen's d = 1.9, P < .001).
  • 69% of patients achieved treatment response, defined as a ≥30% improvement on the CAPS-5.
  • Symptom improvement was rapid and durable, with 61.5% of patients maintaining response up to 6 months.

Conclusions:

  • Preliminary findings suggest that combined ketamine and WET is a promising treatment for severe chronic PTSD.
  • The intervention demonstrates potential for large-magnitude and durable symptom reduction.
  • Further large-scale randomized controlled trials are warranted to confirm efficacy and explore synergistic effects.