Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy
Strategically timed trauma- and attachment-informed psychotherapy to address underlying emotional wounds, paired with ketamine administered in precision-calibrated doses to ensure high-entropy brain states, may be key to improving the quality and duration of ketamine’s therapeutic efficacy for treat...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-03-01
|
| Series: | Psych |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2624-8611/4/1/12 |
| _version_ | 1797442934011854848 |
|---|---|
| author | Sherry-Anne Muscat Glenn Hartelius Courtenay Richards Crouch Kevin W. Morin |
| author_facet | Sherry-Anne Muscat Glenn Hartelius Courtenay Richards Crouch Kevin W. Morin |
| author_sort | Sherry-Anne Muscat |
| collection | DOAJ |
| description | Strategically timed trauma- and attachment-informed psychotherapy to address underlying emotional wounds, paired with ketamine administered in precision-calibrated doses to ensure high-entropy brain states, may be key to improving the quality and duration of ketamine’s therapeutic efficacy for treatment-resistant depression. This approach optimizes the opportunities for change created by ketamine’s known effects as a rapid antidepressant that stimulates synaptogenesis, normalizes neural connectivity and coherence, enhances neuroplasticity, reduces inflammation, and induces high-entropy brain states with associated subjective psychedelic experiences. Ketamine, a non-selective N-methyl-D-aspartate (NMDA) receptor antagonist is a safe, effective, fast-acting dissociative anesthetic that, as a standalone treatment, also exhibits rapid sustained antidepressant effects, even in many patients with treatment-resistant depression. A prior history of developmental trauma and attachment injuries are known primary factors in the etiology of treatment resistance in depression and other mental disorders. Thus, the adjunct of targeted psychotherapy attuned to trauma and attachment injuries may enhance and prolong ketamine efficacy and provide an opportunity for lasting therapeutic change. Psychotherapy engagement during repeated ketamine sessions for patient safety and integration of altered states, paired with separate individualized psychotherapy-only sessions timed 24–48 h post ketamine induction, takes advantage of peak ketamine-induced dendritic spine growth in the prefrontal cortex and limbic system, and normalized network connectivity across brain structures. This strategically timed paired-session approach also exploits the therapeutic potential created by precision-calibrated ketamine-linked high-entropy brain states and associated psychedelic experiences that are posited to disrupt overly rigid maladaptive thoughts, behaviors, and disturbing memories associated with treatment-resistant depression; paired sessions also support integration of the felt sense of happiness and connectivity associated with psychedelic experiences. |
| first_indexed | 2024-03-09T12:49:47Z |
| format | Article |
| id | doaj.art-35431b99743c42219adcb07d84e31b82 |
| institution | Directory Open Access Journal |
| issn | 2624-8611 |
| language | English |
| last_indexed | 2024-03-09T12:49:47Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Psych |
| spelling | doaj.art-35431b99743c42219adcb07d84e31b822023-11-30T22:08:17ZengMDPI AGPsych2624-86112022-03-014111914110.3390/psych4010012Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed PsychotherapySherry-Anne Muscat0Glenn Hartelius1Courtenay Richards Crouch2Kevin W. Morin3Youth Forensic Psychiatry, Alberta Hospital, Alberta Health Services, Edmonton, AB T5Y 6A8, CanadaIntegral and Transpersonal Psychology, California Institute of Integral Studies, San Francisco, CA 94103, USAIntegral and Transpersonal Psychology, California Institute of Integral Studies, San Francisco, CA 94103, USADepartment of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, CanadaStrategically timed trauma- and attachment-informed psychotherapy to address underlying emotional wounds, paired with ketamine administered in precision-calibrated doses to ensure high-entropy brain states, may be key to improving the quality and duration of ketamine’s therapeutic efficacy for treatment-resistant depression. This approach optimizes the opportunities for change created by ketamine’s known effects as a rapid antidepressant that stimulates synaptogenesis, normalizes neural connectivity and coherence, enhances neuroplasticity, reduces inflammation, and induces high-entropy brain states with associated subjective psychedelic experiences. Ketamine, a non-selective N-methyl-D-aspartate (NMDA) receptor antagonist is a safe, effective, fast-acting dissociative anesthetic that, as a standalone treatment, also exhibits rapid sustained antidepressant effects, even in many patients with treatment-resistant depression. A prior history of developmental trauma and attachment injuries are known primary factors in the etiology of treatment resistance in depression and other mental disorders. Thus, the adjunct of targeted psychotherapy attuned to trauma and attachment injuries may enhance and prolong ketamine efficacy and provide an opportunity for lasting therapeutic change. Psychotherapy engagement during repeated ketamine sessions for patient safety and integration of altered states, paired with separate individualized psychotherapy-only sessions timed 24–48 h post ketamine induction, takes advantage of peak ketamine-induced dendritic spine growth in the prefrontal cortex and limbic system, and normalized network connectivity across brain structures. This strategically timed paired-session approach also exploits the therapeutic potential created by precision-calibrated ketamine-linked high-entropy brain states and associated psychedelic experiences that are posited to disrupt overly rigid maladaptive thoughts, behaviors, and disturbing memories associated with treatment-resistant depression; paired sessions also support integration of the felt sense of happiness and connectivity associated with psychedelic experiences.https://www.mdpi.com/2624-8611/4/1/12ketaminetreatment-resistant depressionglutamate modulatorsynaptogenesisinduced neuroplasticityentropic brain states |
| spellingShingle | Sherry-Anne Muscat Glenn Hartelius Courtenay Richards Crouch Kevin W. Morin Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy Psych ketamine treatment-resistant depression glutamate modulator synaptogenesis induced neuroplasticity entropic brain states |
| title | Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy |
| title_full | Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy |
| title_fullStr | Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy |
| title_full_unstemmed | Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy |
| title_short | Optimized Clinical Strategies for Treatment-Resistant Depression: Integrating Ketamine Protocols with Trauma- and Attachment-Informed Psychotherapy |
| title_sort | optimized clinical strategies for treatment resistant depression integrating ketamine protocols with trauma and attachment informed psychotherapy |
| topic | ketamine treatment-resistant depression glutamate modulator synaptogenesis induced neuroplasticity entropic brain states |
| url | https://www.mdpi.com/2624-8611/4/1/12 |
| work_keys_str_mv | AT sherryannemuscat optimizedclinicalstrategiesfortreatmentresistantdepressionintegratingketamineprotocolswithtraumaandattachmentinformedpsychotherapy AT glennhartelius optimizedclinicalstrategiesfortreatmentresistantdepressionintegratingketamineprotocolswithtraumaandattachmentinformedpsychotherapy AT courtenayrichardscrouch optimizedclinicalstrategiesfortreatmentresistantdepressionintegratingketamineprotocolswithtraumaandattachmentinformedpsychotherapy AT kevinwmorin optimizedclinicalstrategiesfortreatmentresistantdepressionintegratingketamineprotocolswithtraumaandattachmentinformedpsychotherapy |