From the Guidelines
Ketamine appears to be a promising treatment for patients with PTSD, particularly for rapid reduction of suicidal ideation, as evidenced by its potential rapid-acting antisuicidal effects 1. When considering ketamine for PTSD treatment, it's essential to weigh the potential benefits against the risks, as noted in the study by Wilkinson and Sanacora 1.
- Typical treatment involves intravenous infusions of 0.5 mg/kg administered over 40 minutes, which has shown promise in reducing suicidal ideation, although more data are needed to make meaningful clinical recommendations 1.
- The effects of ketamine on PTSD symptoms, including suicidal ideation, may be independent of its general effects on mood and anxiety, but further studies are required to confirm this 1.
- Ketamine's potential as a treatment for PTSD is significant, but it's crucial to conduct further research to determine its efficacy and safety in patients with PTSD, particularly those with elevated baseline levels of suicidal ideation 1.
- As with any treatment, ketamine's risks, including dissociation, increased blood pressure, nausea, and dizziness, must be carefully monitored in a controlled medical setting 1.
- Ketamine should be part of a comprehensive treatment plan that includes psychotherapy and should be administered under the supervision of mental health professionals experienced with both PTSD and ketamine treatments.
From the Research
Ketamine for PTSD: Efficacy and Research Findings
- Ketamine has been studied as a potential treatment for post-traumatic stress disorder (PTSD), with research suggesting its efficacy in reducing symptoms of PTSD 2, 3, 4, 5.
- A systematic review and meta-analysis found that ketamine had a statistically significant effect on PTSD Checklist for DSM-5 (PCL-5) scores and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scores in individuals with PTSD 3.
- Another study found that a single dose of intravenous (IV) ketamine facilitated rapid reduction of PTSD symptoms, and repeated IV ketamine administration significantly improved PTSD symptoms in a predominantly civilian sample of individuals with PTSD 4.
- A meta-analysis of randomized controlled trials found that ketamine significantly reduced CAPS scores, PCL scores, and Montgomery-Asberg Depression Rating (MADRS) scores at the maximal follow-up times versus control 5.
Comparison to Other Treatments
- Selective serotonin reuptake inhibitors (SSRIs) are currently the most studied and effective medications for PTSD, with a favorable adverse effect profile, making them the first-line treatment for PTSD 6.
- Ketamine has been found to have similar magnitude of benefit to SSRIs and venlafaxine in reducing PTSD and depression scores, but its longevity of effect needs to be determined 5.
Potential Benefits and Risks
- Ketamine has been found to have potential benefits in reducing PTSD symptoms, including rapid reduction of symptoms and improvement in depression scores 2, 3, 4, 5.
- However, ketamine has also been found to have potential risks, including dry mouth, dizziness, and blurred vision 5.
- Further research is needed to fully understand the benefits and risks of ketamine as a treatment for PTSD, including its potential use in combination with psychotherapy 2, 4.