Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety, as well as uncontrollable thoughts about the event. Many people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may be suffering from PTSD.

Last year 3.6% of the general population had PTSD in the United States. The prevalence of PTSD was high among females (5.2%) as compared to males (1.8%). Ketamine, a traditional medication for anesthesia, produces a dissociation between thalamic-neocortical and limbic systems. This functional and electrophysiological dissociation makes ketamine effective in the treatment of treatment-resistant depression, PTSD, OCD, and anxiety disorders.

Ketamine and PTSD

PTSD is a state related to intrusive thoughts, flashbacks of events, and nightmares. These thoughts are linked with the overactivity of NMDA receptors. Ketamine antagonizes NMDA receptors, thus thought to be reducing the symptoms of PTSD.

In a randomized controlled trial and case reports, ketamine showed almost complete resolution of symptoms of PTSD for a short time period and similar effects as it shows in major depressive disorders (MDD). These improvements were rapid and stayed more than the half-life of ketamine, but unfortunately, these effects were transient and vanished after 1-2 weeks of ketamine administration. Antagonizing effect of ketamine on NMDA receptors reverses the damage caused by chronic stress in PTSD. More investigations are still needed to prove ketamine as a viable tool in the treatment of PTSD.

Repeated Ketamine Administrations and PTSD

Researchers from the Icahn School of Medicine at Mount Sinai conducted research on the effect of repeated administration of ketamine on PTSD. This first randomized, controlled trial of repeated ketamine administration for chronic PTSD, published in the American Journal of Psychiatry in 2021, suggests that repeated administration of ketamine may be effective in treating PTSD.

In this study, patients with PTSD were administered 6 doses of iv ketamine over 2 weeks with a frequency of 3 administrations per week. In comparison, midazolam was administered to the control group. Individuals in this study were patients with chronic and severe PTSD for 14 or more years.

At the end of the study, 67% of patients in the ketamine group showed a significant reduction in symptoms, as compared to 20% of patients in the midazolam group.

Moreover, ketamine responders showed a rapid reduction in symptoms within 24 hours after the first administration, and the effect of ketamine stayed for a median of 27.5 days. Ketamine administrations were well tolerated and safe.

Low dose Ketamine Administrations for Comorbid PTSD

In a double-blinded randomized trial, a single dose of ketamine and or ketorolac was administered to patients with chronic pain with and without PTSD. As a result, both single doses of ketamine(0.5mg/kg) and ketorolac(15mg) showed improvement in PTSD and chronic pain. It revealed that ketamine resulted in a significant reduction in symptoms of core PTSD and its effect stayed for 7 days. Patients with comorbid PTSD and chronic pain experienced fewer dissociative symptoms after the administration of ketamine as compared to patients with chronic pain only. There was no worsening of symptoms after administration of either drug.

Safety and Efficacy of Ketamine for PTSD

A detailed and qualified review of five randomized clinical studies indicated that ketamine administrations exert clear and rapid effects in patients with PTSD and mainly in patients with PTSD resistant to traditional medications. Moreover, Ketamine alleviates comorbidities like chronic pain, alcohol abuse, chronic stress, and major depression. The majority of the results in these randomized controlled trials showed that ketamine is a potent, rapid-acting, and safe medication for PTSD. There was a significant reduction in symptoms in the majority of the patients.

Ketamine induces neuroplasticity, playing an imperative role in PTSD fear extinction. The effect of ketamine prolongs with psychotherapy and the relapse rate reduces significantly. It is well tolerated. Transient dissociation is the only side effect of ketamine that lasts for a few hours and resolves spontaneously.

Isha Health offers ketamine therapy

If you've been diagnosed with major depression, PTSD, or anxiety disorders, and have had no successful treatment with conventional medications, Isha Health may be able to help you with our ketamine therapy. We offer at-home ketamine therapy in the comfort and privacy of your own home. Our team of licensed and experienced clinicians provides personalized and customized online ketamine therapy for each patient.

Contact us for further information and appointment details.

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