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Combined Ketamine and eCBT Intervention for PTSD

Phase 2
Conditions
Post-Traumatic Stress Disorder
Interventions
Behavioral: Online Trauma-Focused Cognitive Behavioural Therapy
Registration Number
NCT04771767
Lead Sponsor
Queen's University
Brief Summary

An open label RCT assessing the efficacy of a combined treatment approach for PTSD, using Ketamine infusions and online Cognitive Behavioural Therapy.

Detailed Description

OBJECTIVES

(i) To introduce a previously untreated patient population with PTSD to new therapeutic options.

(ii) To provide new insights into the functional role of Glutamate in affective disorders as well as in learning and memory.

(iii) To explore the utility of pharmacologically-enhanced psychotherapy.

OUTLINE

The present study is an open label randomized control trial assessing the efficacy of a combined treatment of sub-anaesthetic IV Ketamine in conjunction with online CBT (eCBT). In the study, 16 participants with refractory PTSD will be assigned either to an experimental group receiving a combination of Ketamine and eCBT over 12 weeks, or they will be assigned to a 12-week control group. Both groups will be assessed for symptoms of PTSD and comorbid disorders before treatment, at 2 midway points (4 and 8 weeks), and at the end of the 12 week experimental period. Symptoms of PTSD and comorbid disorders for participants in the experimental group are expected to improve significantly more than participants in the control.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
16
Inclusion Criteria
  • Diagnosis of PTSD by a psychiatrist on the team using the Clinician Administered PTSD Scale (CAPS-5) with a score of at least 50 and a medium presentation.
  • Patients will have received at least 2 different types of prior treatment, both of which produced less than a 50% reduction in the participant's symptoms.
  • Participants with hypertension or cardiovascular disease must be receiving stable treatment to participate.
  • Participants must speak and read English, and will have consistent and reliable access to the internet.
  • Patients with suicidal ideation will be included.
  • Patients with a history of substance abuse will be included (except for opioid use disorder).
Exclusion Criteria

Hypomanic/manic episodes, bipolar disorder, acute psychosis, opioid use disorder, treatment with Naltrexone, pregnancy, postpartum, breastfeeding, untreated hypertension, cardiovascular disease, ASPD, active homicidal ideation, and general noncompliance with the study protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ketamine + eCBTOnline Trauma-Focused Cognitive Behavioural TherapyOver 12 weeks, participants receive weekly sessions of asynchronous online cognitive-behavioural therapy as well as 6 sub-anesthetic infusions of Ketamine
Ketamine + eCBTKetamineOver 12 weeks, participants receive weekly sessions of asynchronous online cognitive-behavioural therapy as well as 6 sub-anesthetic infusions of Ketamine
Primary Outcome Measures
NameTimeMethod
Change in Scores on the Clinician Administered PTSD Scale for DSM-50 weeks from start, 4 weeks from start, 8 weeks from start, and 12 weeks from start

Assessment of PTSD symptoms for diagnosis and severity; score representing the mildest/lack of symptoms: 0; score representing the most severe symptoms: 120.

Secondary Outcome Measures
NameTimeMethod
Change in Scores on the Montgomery Asberg Depression Rating Scale0 weeks from start, 4 weeks from start, 8 weeks from start, and 12 weeks from start

Measure of depression; score representing the mildest/lack of symptoms: 0; score representing the most severe symptoms: 60.

Change in Scores on the Columbia Suicide Severity Rating Scale0 weeks from start, 4 weeks from start, 8 weeks from start, and 12 weeks from start

Measuring thoughts, feelings, and behaviours associated with suicide; score representing the mildest/lack of symptoms: 0; score representing the most severe symptoms: 6.

Change in Scores on the Sheehan Disabilities Scale0 weeks from start, 4 weeks from start, 8 weeks from start, and 12 weeks from start

A brief, patient rated measure of disability and impairment; score representing the mildest/lack of symptoms: 0; score representing the most severe symptoms: 44.

Change in Scores on the Global Assessment of Functioning0 weeks from start, 4 weeks from start, 8 weeks from start, and 12 weeks from start

Assessing the patient's overall capacity to handle life's challenges; score representing the mildest/lack of symptoms: 100; score representing the most severe symptoms: 1.

Trial Locations

Locations (1)

Queen's University

🇨🇦

Kingston, Ontario, Canada

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