A single low-dose infusion of ketamine, an NMDA receptor antagonist, given after recalling a traumatic memory can weaken the fear response associated with post-traumatic stress disorder. In the study, people who received ketamine showed lower activity in the amygdala and hippocampus when re-exposed to trauma memories, compared to those who received midazolam. Ketamine also reduced communication between the amygdala and hippocampus, without affecting connections to the prefrontal cortex. These changes lasted at least 30 days after treatment, suggesting that human traumatic memories can be altered during a reconsolidation window, potentially offering a new approach to treating PTSD.
A single dose of a dissociative drug altered resting-state functional connectivity between frontal and limbic brain regions in individuals with posttraumatic stress disorder, suggesting a potential mechanism for its therapeutic effects. The randomized controlled pilot study compared drug versus placebo in a small sample, finding changes in connectivity patterns that may relate to symptom reduction. The authors indicate that these preliminary results warrant further investigation in larger trials.
Palliative care clinicians view existential distress as a common and often inadequately treated psychosocial-spiritual problem that resists purely medical approaches. They see psychedelic-assisted therapies (PAT) as a potentially powerful tool for refractory existential distress but believe a stronger evidence base is needed. Because PAT do not fit existing treatment models, barriers remain, including stigma and limited education about their medical use. Larger clinical trials and educational outreach are needed to clarify treatment targets and address safety concerns, and integration into palliative care should emphasize collaboration with spiritual care and mental health providers while addressing equitable access.