2010) dementia or suspicion thereof, are excluded. Patients with a diagnostic history of borderline personality disorder, obsessive compulsive disorder, schizophrenia or schizoaffective disorder or currently exhibiting psychotic features as determined by the Structured Clinical Interview for DSM (SCID) (First, et al.Able to provide written informed consent.Following randomization, small changes to doses may be allowable at the PI’s discretion. Subjects on FDA-approved antidepressant, trazodone, atypical neuroleptic, prazosin, or clonidine may enter the study if they have been on a stable treatment, as determined by the study clinician, for at least 4 weeks prior to randomization.severe PTSD) on the Clinician-Administered PTSD Scale (CAPS-5) at screening. Diagnosis of PTSD with a score of 25 or higher (i.e.Must not have a medical/neurological problem or use medication that would render ketamine unsafe by history or medical evaluation.Females will be included if they are not pregnant and agreed to utilize a medically accepted birth control method (to include oral, injectable, or implant birth control, condom, diaphragm with spermicide, intrauterine device, tubal ligation, abstinence, or partner with vasectomy) or if post-menopausal for at least 1 year, or surgically sterile. Adults in the 18-20 ranges have been eliminated because previous experience indicates that they often lack the maturity to participate effectively in similar protocols. This age range was chosen to fit with prior samples in which no adverse effects of ketamine have been observed. Male or female between the ages of 21-70 years.Aim 1: To examine the feasibility to recruit, randomize, retain, and assess participants in a one-week exposure therapy combined with a series of two ketamine infusions.Īim 2: To demonstrate the beneficial effects of combining low dose ketamine (0.5 mg/kg or 0.2mg/kg infused over 40 min) and intensive prolonged exposure (PE) therapy on PTSD symptoms as assessed by structured interviews and behavioral ratings.Īim 3: To assess changes in the brain's functional connectivity and hyper-reactivity in the "mood" and "memory" network which include: the amygdala, striatum, insula, anterior cingulate cortex, hippocampus and prefrontal cortex in pre and post treatment task listening to the trauma narrative/neutral narrative/and a significant non-traumatic memory narrative pre and post treatment.Īim 4: To demonstrate the ability of ketamine treatment to restore structural connectivity by using diffusion weighted imaging (DTI) and global probabilistic tractography with anatomical priors, we will estimate the cingulum fractional anisotropy (FA) at baseline, and post treatment.
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