Discussion
depression, anxiety
EVENTS
Our study found that the rapid effects of ketamine can be made more enduring with simple, portable, digital techniques that would be relatively easy to provide to patients in a wide range of settings. One 40-minute drug administration, followed by 4 days (30-40 min/d) of digital exercises, created a statistical effect on depression that endured for 3 months according to the new follow-up phase data presented here—even in the context of naturalistic treatment changes across all groups. However, this benefit was not sustained in months 4 to 12.Study limitations include lack of a no-treatment (saline plus sham) group, precluding conclusions regarding the effect of ASAT as a standalone intervention given that all participants received at least 1 active intervention component, and low base rates of clinically impactful outcomes (eg, suicidal events). Future research is needed to make the initial effect size both larger (given persistent mild-to-moderate average depression levels observed in all study groups) and more durable, potentially through repeated drug administrations, booster sessions of the digital therapy (including at-home administration), and/or additional conditioning modules to target other implicit cognitive patterns. Similar techniques could be tested for their potential to produce rapid, efficient, non–resource-intensive, and relatively enduring relief for a wide variety of common psychological conditions, including suicidality, anxiety, and more.