Hyperbaric Oxygen Therapy for Treatment-Resistant Posttraumatic Stress Disorder without Traumatic Brain Injury: A Retrospective Cohort Study

Abstract

Introduction: Hyperbaric oxygen therapy (HBOT) is a procedure used for indications such as wound healing due to its ability to promote neovascularization. For this reason, HBOT is being adapted for use in stroke, traumatic brain injury (TBI), and now in psychiatric disorders such as posttraumatic stress disorder (PTSD). The current study examines the possible efficacy of HBOT for improving PTSD-related symptoms without the context of TBI. Methods: Retrospective cohorts for PTSD patients without TBI were obtained through the TriNetX database. The treatment cohort had a history of HBOT and the control cohort did not have any HBOT. All PTSD patients had a history of both psychotherapy and pharmacotherapy to confer treatment resistance and PTSD severity. Results: The treatment group was associated with a significantly higher risk for sleep disorders (RR = 1.23 (95% CI (1.06, 1.43)), OR = 1.48 (95% CI (1.11, 1.97)), P = .007) and for depressive episodes (RR = 1.15 (95% CI (1.04, 1.27)), OR = 1.52 (95% CI (1.12, 2.06)), P = .007). No other outcome measured was significantly different between the two cohorts. Discussion: HBOT was not associated with improved PTSD-related symptoms in our study. Several factors may have led to these results such as lack of HBOT dosing data, long follow-up times, and lack of clinical symptom scales to confer disorder severity. Conclusion: Though the current study did not support current evidence that HBOT is an effective adjunct treatment for treatment-resistant PTSD, further studies are needed to better illustrate this relationship.