Ketamine Therapy for Teens with PTSD? Researchers Say Yes.

UW-Madison researchers are planning a groundbreaking study to examine the potential of ketamine in treating adolescents with post-traumatic stress disorder (PTSD). This study, led by Dr. Ryan Herringa, a child psychiatrist at UW Health, is believed to be the first to combine ketamine with psychotherapy for teens with PTSD.

The research aims to address the limitations of current PTSD treatments for adolescents. Many teens with PTSD, often caused by experiencing years of abuse or witnessing violence, struggle to discuss their trauma in traditional psychotherapy. Ketamine's mind-altering effects, when combined with counseling, may allow these young patients to better process and work through their traumatic experiences.

The potential benefits of ketamine-assisted psychotherapy for adolescents are substantial, including reduced depression, alleviated suicidal ideation, and improved emotional well-being. Previous studies have shown promising results, with one study reporting a 76% response rate within three days of a single ketamine infusion in adolescents with major depressive disorder.

How, exactly, will this therapeutic process work, though?

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In case you’re wondering, the study’s co-principal investigator, Christopher Nicholas, PhD., a specialist in neuroscience and clinical psychology at UW-Madison, explained that patients will not undergo talk therapy while under the influence of ketamine. Talk therapy will occur before and after the ketamine sessions. Therapists will monitor the patient, who will be encouraged to use a combination of cognitive behavioral therapy practices and “mindfulness” throughout and after the sessions.

All told, the study will enroll five participants ages 15 to 17 with PTSD. They will receive three 90-minute intravenous ketamine infusions over six weeks at UW Health's American Family Children's Hospital, with two therapists on hand for counseling. This early-stage trial will assess the safety of administering ketamine to teens and explore its impact on their PTSD symptoms.

While ketamine is relatively safe when used as directed by a licensed medical professional, it does pose some dangers. Namely, there is a risk of developing an addiction to the drug, and an overdose can cause cardiac arrest. 

However, UW-Madison’s researchers have already built safeguards into the clinical trial. For starters, all study participants will be “screened out” if they have a history of substance abuse, Nicholas said. Furthermore, all participants will be regularly medically and psychologically assessed throughout the trial. 

And, perhaps most importantly, every participant will be assigned an adult caretaker to monitor them outside of the clinic, preferably someone who is a family member, legal guardian, or mentor. Christopher acknowledges the risks but also notes that they are less severe than clinical trials with other drugs. “To date, ketamine studies with adolescents and adults have not reported [developing an addiction] as a significant risk when ketamine is solely administered in a controlled medical setting,” he said, “and there is adjunctive monitoring and therapeutic support.”

This research is part of a broader focus on psychoactive medicine for mental health disorders at UW-Madison and nationwide. Other studies at the university have explored the use of psilocybin, the psychedelic compound in "magic mushrooms," for treating opioid and meth addiction. Initial results from these studies have shown promise, with some participants experiencing reduced drug use.

While there is growing interest in psychedelic therapies, the field has faced some setbacks. In August, the FDA rejected MDMA (ecstasy) for PTSD treatment, requesting additional clinical trials to support its safety and efficacy.

As research in this field progresses, it's crucial to consider the safety and ethical implications of using psychoactive substances in adolescent mental health treatment. However, the potential for breakthrough treatments in addressing the current adolescent mental health crisis very possibly outweighs the inherent risks. 

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