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Generalized Anxiety Disorder among Cannabis Consumers before and after Ketamine-Assisted Psychotherapy: Results from a Pilot Study Comparing Psycholytic and Psychedelic Approaches

Yash Agrawal
University of Miami

Co-Authors: Daniella Batievsky1, Shari Kaplan1, Michelle Weiner1, Denise C. Vidot2
1Spine and Wellness Centers of America 2University of Miami

Background
Alternative methods to manage anxiety have been exercised to mitigate increased utilization of mental health services. Cannabis has been used to mitigate anxiety; however, legal access varies since anxiety is rarely a medical cannabis qualifying condition. Ketamine is legal for use; but it is unclear how anxiety symptoms are impacted by the co-use of ketamine and cannabis. The purpose of this study was to conduct a sub-analysis of generalized anxiety disorder among adults in a pilot Ketamine-Assisted Psychotherapy (KAP) intervention study. 

Methods
A sub-analysis of data of cannabis consumers (N=10) from a pilot intervention study comparing two 6-week long KAP approaches to determine the optimal route of administration in patients with major depressive disorder and chronic pain. Generalized Anxiety Disorder (GAD-7) Scale scores were summed at baseline, timepoint 1, timepoint 2, and timepoint 3. 

Results
All participants’ anxiety symptoms declined throughout treatment as evidenced by the sum of their responses on the GAD-7. Participants (n=5) who consumed the psychedelic treatment dose (high doses administered intramuscularly 24 hours before therapy) saw a larger, more consistent decrease at each time point. All ten participants transitioned from having a severe GAD diagnosis at baseline (mean scores above 15 points) to having a moderate GAD diagnosis by treatment termination (mean scores below 15 points). A larger overall decrease in symptoms was seen in the psychedelic group, whose mean symptoms decreased by 19.57% by the study’s completion in comparison to the psycholytic group, whose mean symptoms decreased by 16.25% by the study’s completion. Furthermore, the psychedelic group’s mean symptoms consistently declined throughout the course of treatment (T=1= 9.78% decrease, T-2=8.43% decrease, T-3=2.64% decrease). The psycholytic group’s mean symptoms, on the other hand, increased after the third treatment session (T-1 = 13.57% decrease, T-2 = 8% increase, T-3=10.67% decrease)

Conclusions
KAP among cannabis consumers resulted in a reduction of anxiety symptoms over time, particularly among the psychedelic dose group. Future studies should examine the relationship between ketamine and cannabis co-use and their impact on anxiety symptoms among larger sample sizes.

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