Ketamine-Assisted Psychotherapy for Generalized Anxiety Disorder: A Comprehensive Case Report with Integrated Neurophysiological Imaging Using Magnetoencephalography
J Cohen, AC Reichelt, R Zamyadi, G Roberts, S Hardy, B Fernandes, SG Rhind, EC Lewis, V Bhat, M Palner, R Jetly, BT Dunkley
medRxiv Preprint Server February 25, 2025 preprint DOI: 10.1101/2025.02.25.25322463 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Longitudinal Case report |
|---|---|
| Sample size | 1 |
| Population | Adult male with moderate-severe generalized anxiety disorder and depressive symptoms |
| Intervention | Ketamine-assisted psychotherapy |
| Duration | 4 of 6 sessions of ketamine administration and 2 integration sessions (part of a protocol of six KAP sessions and four integration sessions) |
| Topics | Neuroplasticity Anxiety Esketamine Ketamine Psychedelic-assisted therapy |
| Keywords | Ketamine therapy Mental health |
| Citations | 1 |
| Key findings | Ketamine-assisted psychotherapy was associated with increased functional connectivity in four of five brain networks, increased beta activity, decreased theta oscillations, and reductions in anxiety and depression scores. |
Abstract
This detailed case report explores the application of ketamine-assisted psychotherapy (KAP) in the treatment of a male patient in their late 30’s with Generalized Anxiety Disorder (GAD) and depressive symptoms. The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine represents a significant breakthrough in the treatment of mood and anxiety disorders due to its rapid and robust antidepressant effects. Preclinical studies demonstrate that ketamine promotes biological alterations in the brain, including enhancing neuroplasticity. However, no studies to date have examined the longitudinal effects of KAP using magnetoencephalography (MEG), a powerful functional neuroimaging modality. Resting state MEG (rsMEG) scanning allowed the exploration of the neural correlates of KAP-related changes in mood and anxiety symptoms, including the functional connectivity between brain networks involved in cognition and emotion regulation. In this case study, an adult male participant with moderate-severe GAD underwent two rsMEG scans and cognitive testing at baseline and after 4 of 6 sessions of a standard ketamine administration and 2 integration sessions, part of a protocol consisting of a total of six KAP sessions and four sessions of integration. We measured functional connectivity in 5 functional networks – default mode, attention, central executive, motor, and visual, as well as neural oscillatory activity. We saw functional connectivity increases in 4 of the 5 networks. This coincided with significant increases in cortical beta activity, a marker of inhibition, decrease in theta oscillations, reductions in GAD7 and PHQ9 scores, and improved attention. In summary, these findings emphasize the ability of rsMEG to detect KAP-induced brain network changes, offering a promising tool for identifying clinically relevant neural correlates that can both predict and monitor therapeutic outcomes via electrophysiological changes.
Comparable studies
Other case reports and case series on ketamine and psychedelic-assisted therapy, most cited first.
Citations in the library
Cites 18
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
- Mechanisms of Ketamine Action as an Antidepressant Molecular Psychiatry March 13, 2018
- Ketamine for rapid reduction of suicidal thoughts in major depression: a midazolam-controlled randomized clinical trial American Journal of Psychiatry December 5, 2017
- Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression The International Journal of Neuropsychopharmacology October 8, 2013
- Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy Journal of Psychoactive Drugs March 15, 2019
and 13 more in the library