Ketamine-Assisted Psychotherapy

Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder

American Journal of Psychiatry · 2022

This phase 2 trial tested whether ketamine, combined with talk therapy, could help people with severe alcohol use disorder stay abstinent. Ninety-six adults were randomly assigned, double-blind, to three weekly ketamine or saline infusions, paired with either mindfulness-based relapse prevention therapy or alcohol education. In this study, the ketamine groups had more days without alcohol at six months than the placebo groups, an average difference of about 10%, and the largest difference was between ketamine plus therapy and saline plus education. There was no significant difference in relapse rates, and the treatment was well tolerated. The authors describe it as a proof-of-concept study with wide confidence intervals, so the results need confirming in larger trials.

Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy

Journal of Psychoactive Drugs · 2019

This paper describes Ketamine Assisted Psychotherapy (KAP), an approach in which ketamine is given alongside psychotherapy and its psychedelic qualities are treated as part of the therapeutic process rather than as unwanted side effects. The authors gathered demographic and outcome data from 235 patients across three private practices using similar methods, mostly without intravenous access. In this study, patients showed decreases in depression and anxiety, and the authors report the changes were especially notable for older patients and those with more severe symptoms. An honest limitation: this was an observational report from the treating practices themselves, with no control group or randomization, so it cannot show that KAP caused the improvements.

Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression

JAMA Psychiatry · 2019

This phase 3 trial looked at whether continuing esketamine nasal spray helps people with treatment-resistant depression stay well after they improve. Of 705 adults enrolled, 297 who reached stable remission or stable response after 16 weeks of esketamine plus an oral antidepressant were randomly assigned, double-blind, to keep using esketamine or switch to a placebo spray while staying on their antidepressant. In this study, among those in stable remission, 26.7% relapsed on esketamine versus 45.3% on placebo, and among those in stable response, 25.8% versus 57.6%. Temporary altered taste, vertigo, dissociation, sleepiness and dizziness were the most common side effects. A limitation is that only people who had already done well on esketamine were randomized, so results may not apply to everyone.