PTSD has few effective pharmacological treatments, and trauma-focused psychotherapies are limited by provider shortages and low patient engagement, often leading to chronic illness and reduced quality of life. Ketamine, an NMDA receptor antagonist already indicated for major depression with rapid antidepressant effects, shows transdiagnostic potential. A synthesis of clinical evidence—including case reports, chart reviews, open-label studies, and randomized trials—reveals high heterogeneity in presentation and treatment approach but encouraging signals of safety, efficacy, and durability. Future research directions are discussed.
A single dose of vaporized bufotoxin from the Sonoran Desert Toad, containing an estimated 10-15 mg of 5-MeO-DMT, produced clinically significant improvements in chronic, treatment-resistant PTSD in a 23-year-old female. Next-day effects included marked reductions in hopelessness and suicide risk, with improvements sustained at 1-, 3-, 6-, and 12-month follow-ups. The subject reported a complete mystical experience, which may underlie the therapeutic activity. No serious adverse events occurred, but acute nausea, overwhelming subjective effects, and late-onset night terrors were reported. Results suggest 5-MeO-DMT is generally tolerable and effective for PTSD, though the findings are non-generalizable and rely on methods not clinically accepted.