A case series of group-based ketamine-assisted psychotherapy for patients in residential treatment for eating disorders with comorbid depression and anxiety disorders

Summary & key facts

This small report followed five people in residential treatment for an eating disorder who also had depression and anxiety. They took part in group sessions where each person received a ketamine injection into the muscle once a week for four weeks. Researchers used standard questionnaires to measure depression and anxiety before each dose, about four hours after, and about 24 hours after. Four of the five people showed a meaningful drop in their depression scores after the final session, and two of the five showed a meaningful drop in anxiety scores. The injections were generally well tolerated and there were no serious side effects. The authors say this suggests group-based ketamine-assisted psychotherapy might be a useful add-on to specialized eating-disorder care, but the study is very small and cannot prove the treatment caused the improvements.

Key facts:

• Five people in residential eating-disorder treatment with mood and anxiety disorders took part in the report.
• Each person received a weekly ketamine injection into the muscle in a group setting for four weeks.
• Depression and anxiety were measured before dosing, about four hours after dosing, and about 24 hours after dosing.
• Four of the five people had a clinically meaningful improvement in depression after the last ketamine session, which means their depression questionnaire score dropped by more than five points.
• Two of the five people had a clinically meaningful improvement in anxiety after the last session, which means their anxiety questionnaire score dropped by more than four points.
• Dosing sessions were described as well tolerated and there were no serious adverse events reported.
• Because this was a very small, uncontrolled report, the results are preliminary and cannot prove that ketamine caused the improvements.

Abstract

BACKGROUND: Depression and anxiety outcome measures, safety/tolerability, patient satisfaction, and ease of implementation of group-based ketamine-assisted psychotherapy (G-KAP) delivered to patients in intensive residential eating disorder (ED) treatment were assessed. CASE PRESENTATION: This study reports on five participants with a diagnosis of an ED and comorbid mood and anxiety disorders who received weekly intramuscular ketamine injections in a group setting over 4 weeks. Measures of anxiety (GAD-7) and depression (PHQ-9) were administered pre-dose, 4-h post-dose, and 24-h post dose. Four of the 5 participants experienced clinically significant improvements on the PHQ-9 score (i.e., change greater than 5) while 2 of the 5 participants experienced clinically significant improvements on the GAD-7 score (i.e., change greater than 4) from pre-dose to 24-h post-dose after the last ketamine session. Dosing sessions were well tolerated, and no serious adverse events were reported. Clinical observations and participant reports corroborated improvements in depression and anxiety symptoms, good tolerability of ketamine treatment, and practical implementation of the G-KAP protocol in a residential ED treatment center. CONCLUSIONS: This study suggests the potential utility of G-KAP as an adjunct to intensive, specialized ED treatment. Overall, this novel, cross-diagnostic intervention warrants future research to further explore its appropriateness in a treatment setting.

Topics

Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Eating Disorders and Behaviors Treatment of Major Depression

Categories

Health Sciences Medicine Pharmacology

Tags

Adverse effect Anxiety Clinical psychology Depression (economics) Dosing Eating disorders Economics Internal medicine Ketamine Macroeconomics Medicine Mood Psychiatry Tolerability

Substances

Ketamine

Conditions & symptoms

Anxiety Depression Eating Disorder Anxiety or worry Poor appetite or overeating Sadness or low mood