The Metabolic Link
The Metabolic Link
Treating PTSD When Standard Care Falls Short: A Hyperbaric Oxygen Protocol | Dr. Keren Doenyas-Barak, MD | The Metabolic Link Ep. 97
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Fewer than 40% of people with PTSD respond to standard care. For the intrusive symptoms at the core of the disorder, response rates may be lower than 15%. So what options remain for patients who have not responded to existing treatments?
Dr. Keren Doenyas-Barak, director of the PTSD program at the Sagol Center for Hyperbaric Medicine and Research and a faculty member at Tel Aviv University, has treated close to 1,000 civilian and military patients and led sham-controlled trials that are helping reshape how hyperbaric medicine is studied.
She walks host Dr. Dominic D'Agostino through the protocol her clinic uses—60 sessions over 12 weeks, with oxygen cycled at two atmospheres—the 35% CAPS-score improvement associated with continued progress after treatment ends, and the reported two-year outcomes, including improved occupational function, roughly double the proportion of patients living with a partner, and sharp drops in benzodiazepine and cannabis use. She also details the convincing sham control her team engineered after concluding that earlier placebo arms may have delivered a physiologically active dose.
Questions Answered in This Episode:
- What hyperbaric protocol is best supported for treatment-resistant PTSD?
- What does a 35% reduction in CAPS score predict about long-term recovery?
- Which outcomes beyond symptom scores changed most for patients?
- How did the team build a hyperbaric sham that patients genuinely could not detect?
- Which safety measures are non-negotiable in a hyperbaric PTSD clinic?
- Does a patient's baseline metabolic fitness predict their response to HBOT, and can the treatment affect cardiometabolic risk?
A rigorous, frontline examination of what responsible hyperbaric medicine actually requires, led by a clinician helping to build its evidence base.
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