Anya Ragnhildstveit – Research on Capitol Hill 2021
(Mentor: Patricia Henrie-Barrus)
Subanesthetic ketamine — a noncompetitive N-methyl-D-aspartate (NMDA) glutamatergic receptor antagonist — has come into psychiatric use as a groundbreaking intervention for major depressive disorder (MDD). Recently, studies have found ketamine assisted psychotherapy (KAP) to be significantly more effective in reducing depression than ketamine alone, given its chronic and refractory nature. Yet neither ketamine- nor KAP-based models have explored the utility of grounding during a largely dissociative experience. Such ego-dissolving, out-of-body, mind-wandering, and reality-detaching effects of ketamine — though therapeutic for most and transient in nature — can produce non-therapeutic responses. Negative emotions such as fear and anxiety as well as disintegration (fragmented self-concepts of identity, values, beliefs, and perceptions) may occur, attenuating clinical benefit. Within a pilot randomized controlled trial (RCT), we aim to test the feasibility and preliminary effectiveness of affective tactile grounding (ATG), as an adjunct technique to KAP, to improve psychedelic states and treatment outcomes for adults with MDD. Potential mechanisms of improvement (dissociation, nondual awareness, emotional stability, and psychological detachment) will also be explored. Participants (N=12) will be randomly assigned to receive six sessions of KAP plus ATG (treatment) or KAP alone (standard of care control). KAP sessions will include preparatory psychotherapy (30 minutes) and intravenous ketamine (0.5 mg/kg) plus therapist-guided psychotherapy over 40 minutes. All participants will receive one counseling session (50 min) prior to any KAP treatment. KAP will be scheduled on a weekly interval (two sessions per week over 21 days), with participants completing self-report measures at baseline and one-week post-intervention in addition to brief clinician-administered measures immediately following each KAP session. It is anticipated that adjunctive ATG will be associated with high feasibility, credibility, and acceptability as well as improvements in psychedelic states during treatment to mediate KAP’s anti-depressive effect. This randomized study will provide the first clinical evidence that KAP plus ATG can improve psychedelic states and overall treatment outcomes for adults with MDD.
House Representative: Jeffrey D. Stenquist
Senate Representative: Daniel McCay