ArticleThe international journal of neuropsychopharmacology2026
Ketamine effects on EEG and their links to therapy differ across treatment-resistant major depression, post-traumatic stress disorder, and obsessive-compulsive disorder.
Article in The international journal of neuropsychopharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionNeurotic disorders-major depressive disorder (MDD), panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobia-have differing pharmaceutical profiles. But all, even when resistant to conventional treatment (TR), respond quickly to low-dose (0.5-1.0 mg/kg I.M.) ketamine. We explore the variation in the neural effects of ketamine across its treatments of TR-MDD, TR-PTSD, and TR-OCD. MATERIALS AND
methodsWe recorded 10 min of resting frontal activity and diagnosis-related scale measures, before and 2 h after fentanyl (50 mcg) or ketamine (0.5 or 1.0 mg/kg, I.M.) counterbalanced across 3 sessions at least a week apart. Average power spectra were calculated for delta, theta, alpha1, alpha2, beta, and gamma bands. Analysis of variance compared TR-PTSD (20 F, 2 M) with TR-MDD (12 F, 13 M). Preliminary TR-OCD (5 F, 2 M) data were also obtained.
resultsTR-PTSD patients showed dose- and band frequency-dependent electroencephalography (EEG) power changes (particularly alpha at 0.05 mg/kg), while TR-MDD patients did not. TR-OCD differed qualitatively from both. The correlation of power change with score change was maximal for different bands and electrodes across the different scales (Impact of Events Scale-Revised, Montgomery-Åsberg Depression Rating Scale, Hospital Anxiety and Depression Scales, Hamilton Anxiety Scale, Fear Questionnaire, and Yale-Brown Obsessive-Compulsive Scale). DISCUSSION: Ketamine effects and their therapeutic links vary in band and site with conventional diagnosis-including previous TR anxiety results. The EEG results appear to detect changes in the disorder-specific systems that conventional treatments target selectively and directly and these appear to require a ketamine-sensitive factor (as a "double hit") to generate disorder.
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