Maintenance Intramuscular Ketamine-Assisted Psychotherapy, a Retrospective Chart Review of Efficacy, Adverse Events, and Dropouts from a Community Practice.
Journal of psychoactive drugs – November 22, 2024
Source: PubMed
Summary
Ketamine-assisted psychotherapy shows remarkable promise, with over 80% of patients experiencing significant improvement in depression symptoms. This long-term study tracked 70 patients through 1,114 therapy sessions, revealing that regular maintenance treatments effectively sustained mental health benefits. The combined approach of ketamine with psychotherapy helped patients manage depression, anxiety, and substance use issues. While most side effects were minimal, one case of ketamine addiction occurred. Most patients who discontinued treatment cited practical reasons rather than medical concerns, and many continued treatment beyond one year.
Abstract
The use of ketamine and ketamine-assisted psychotherapy (KAP) for treatment of depression has grown dramatically, though much of these data are short term. The clinical profile of maintenance treatment remains poorly characterized. We assessed maintenance KAP for efficacy, tolerability, and reasons for dropout. This observational study retrospectively analyzed electronic health records from an addiction psychiatry practice offering intramuscular ketamine with contemporaneous psychotherapy for the treatment of depression. All patients receiving treatment between January 2016 and September 2022 were included, yielding 1,114 sessions from 70 patients. The response was quantified via the clinical global impression-severity scale. Side effects and reasons for dropout were extracted from charts. Comorbidities include an anxiety disorder (79%) or substance use disorder (49%). The induction yielded 82% response, maintained above 80% after six months (sessions q21 days, 1.13 mg/kg mean dose). Many (38%) remained in treatment for at least one year. Nausea management accounted for nearly all as-needed medication use. Antihypertensives were seldom utilized. Chronic side effects were notable for one case of ketamine use disorder, resulting in residential treatment. Dropouts cited logistical reasons half the time and side effects only 9.7% of the time. KAP yielded robust improvements in mood, anxiety, and substance use. Maintenance sessions effectively extended benefit and were largely well tolerated.