The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence.
Anya Ragnhildstveit, Jeremy Roscoe, Lisa C. Bass, Christopher L. Averill, Chadi G. Abdallah, Lynnette A. Averill
Therapeutic Advances in Psychopharmacology 2023 DOI: 10.1177/20451253231154125 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Open-label Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Esketamine Ketamine |
| Keywords | Clinical evidence Pharmacotherapy Rapid-acting antidepressant raad PTSD Therapy Trauma treatment Esketamine therapy |
| Citations | 49 |
| Key findings | Ketamine shows encouraging signals of therapeutic safety, efficacy, and durability for PTSD, though clinical heterogeneity is high. |
Abstract
Posttraumatic stress disorder (PTSD) is a devastating condition, for which there are few pharmacological agents, often with a delayed onset of action and poor efficacy. Trauma-focused psychotherapies are further limited by few trained providers and low patient engagement. This frequently results in disease chronicity as well as psychiatric and medical comorbidity, with considerable negative impact on quality of life. As such, off-label interventions are commonly used for PTSD, particularly in chronic refractory cases. Ketamine, an N-methyl-D-aspartate (NDMA) receptor antagonist, has recently been indicated for major depression, exhibiting rapid and robust antidepressant effects. It also shows transdiagnostic potential for an array of psychiatric disorders. Here, we synthesize clinical evidence on ketamine in PTSD, spanning case reports, chart reviews, open-label studies, and randomized trials. Overall, there is high heterogeneity in clinical presentation and pharmacological approach, yet encouraging signals of therapeutic safety, efficacy, and durability. Avenues for future research are discussed.