Combining Ketamine and Online Cognitive Behavioural Therapy for the Treatment of Posttraumatic Stress Disorder

Abstract

Over a third of patients with Post-Traumatic Stress Disorder (PTSD) do not respond to current pharmacological and psychotherapeutic interventions due to a host of neurobiological and social factors. Ketamine is one potential treatment avenue aimed at boosting neuroplasticity, however its effects are short lived. Online Cognitive Behavioural Therapy (eCBT) is another option, targeting a lack of treatment access, however it can struggle to overcome cognitive rigidity in treatment-resistant patients. Administering ketamine in conjunction with psychotherapy is one potential means of potentiating its effects, however, there are few studies investigating this treatment method to date, and none testing ketamine in combination with eCBT. The present study assesses the efficacy of a combined treatment of sub-anesthetic ketamine in conjunction with eCBT. In the study, 10 participants with refractory PTSD were assigned either to an experimental group receiving a combination of ketamine and eCBT over 12 weeks, or they were assigned to a control group where they were passively observed for the same length of time. Both groups were assessed for symptoms of PTSD and comorbid disorders before treatment, at 4-weeks, 8-weeks, and at the end of the 12-week experimental period. Symptoms for participants in the experimental group improved more than in the control group with a large effect size, however the results were not significant. This thesis outlines innovative avenues for addressing treatment resistance in PTSD, and sheds light on treatment access, trauma, and neuroplasticity.