Rohde Judith, Hickmann Elena, Buchmann Marco, Kronenberg Golo, Vetter Stefan, Seifritz Erich, Kleim Birgit, Olbrich Sebastian
Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, Lenggstrasse 31, CH-8032 Zurich, Switzerland.
Department of Psychology, University of Zurich, Binzmuehlestrasse 14, CH-8050 Zurich, Switzerland.
Behav Sci (Basel). 2024 Aug 16;14(8):717. doi: 10.3390/bs14080717.
This pilot case series investigated the feasibility and efficacy of an eight-week therapy program, combining nasally administered ketamine (0.5 mg/kg) with trauma-focused psychotherapy, for individuals with chronic, treatment-resistant post-traumatic stress disorder (PTSD).
Three patients with chronic, treatment-resistant PTSD underwent the eight-week therapy program. Clinical assessments included the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Hamilton Depression Rating Scale (HAMD) at baseline, post-assessment, and follow-up assessment, along with additional measures assessing other relevant symptoms and side effects.
The results demonstrated clinically relevant reductions in PTSD symptoms, indicated by a change in the CAPS-5 score at post-assessment ( = -18.00; = 6.48) and follow-up assessment ( = -25.33, = 5.58). Additionally, depressive symptoms showed notable improvement, with changes in HAMD scores at post-assessment ( = -8.33, = 3.07) and follow-up assessment ( = -9.00, = 3.77). Positive effects were also observed in anxiety reduction, decreased dissociations, and improvements in emotion regulation and disturbances of self-organization.
Despite potential variations in clinical profiles among the patients, the therapy program demonstrated positive outcomes for all participants. Nasally administered ketamine was well tolerated and resulted in immediate symptom reduction in tension, anxiety, and common PTSD symptoms. However, to validate these findings and compare treatment efficacy, future randomized controlled trials are warranted, especially in comparison with trauma-focused therapy alone.
本试点病例系列研究了为期八周的治疗方案的可行性和有效性，该方案将经鼻给予氯胺酮（0.5毫克/千克）与创伤聚焦心理治疗相结合，用于治疗慢性、难治性创伤后应激障碍（PTSD）患者。
三名慢性、难治性PTSD患者接受了为期八周的治疗方案。临床评估包括在基线、评估后和随访评估时使用《精神疾病诊断与统计手册》第5版临床医生管理的PTSD量表（CAPS-5）和汉密尔顿抑郁量表（HAMD），以及评估其他相关症状和副作用的额外测量。
结果显示PTSD症状有临床相关的减轻，评估后CAPS-5评分变化表明了这一点（=-18.00；=6.48），随访评估时也是如此（=-25.33，=5.58）。此外，抑郁症状有显著改善，评估后HAMD评分变化（=-8.33，=3.07），随访评估时也是如此（=-9.00，=3.77）。在减轻焦虑、减少解离以及改善情绪调节和自我组织障碍方面也观察到了积极效果。
尽管患者的临床特征可能存在差异，但该治疗方案对所有参与者都显示出了积极结果。经鼻给予氯胺酮耐受性良好，并能立即减轻紧张、焦虑和常见的PTSD症状。然而，为了验证这些发现并比较治疗效果，未来有必要进行随机对照试验，特别是与单独的创伤聚焦治疗进行比较。
