Effects of Intravenous Ketamine on Posttraumatic Stress Disorder ( PTSD ): A Systematic Review
Liyang Yin, A. Imamog ̄lu, Gia Han Le, Christine E. Dri, Sabrina Wong, Kayla M Teopiz, Huji Xu, Sabrina Wong, Taeho Greg Rhee, Heidi Ka Ying Lo, Maria‐christina Sioufi, Yang Jing Zheng, Hezekiah C.t. Au, Hernán F Guillen-Burgos, Bing Cao, Roger S McIntyre
Acta Psychiatrica Scandinavica December 1, 2025 DOI: 10.1111/acps.70053 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Sample size | 323 |
| Population | Persons with PTSD |
| Intervention | intravenous ketamine |
| Dose | 0.2mg/kg, 0.5mg/kg |
| Topics | Ketamine Esketamine PTSD |
| Keywords | Posttraumatic stress Psychological intervention Anesthesia Medline |
| Citations | 3 |
| Key findings | Intravenous ketamine may be efficacious in treating PTSD, with multi-infusion schedules and repeated lower doses (0.2 mg/kg) showing greater or more sustained effects. |
Abstract
ABSTRACT Introduction Posttraumatic stress disorder (PTSD) is a mental disorder resulting from exposure to traumatic events. Evidence suggests that ketamine may be efficacious in treating PTSD, however, ketamine's mechanisms in treating PTSD remain unclear. Herein, this review aims to evaluate the clinical outcomes of ketamine treatment in persons with PTSD and investigate the possible neurobiological mechanisms underlying ketamine's therapeutic effect in PTSD.
Methods: A systematic search was conducted on PubMed and OVID (MEDLINE, Embase, PsychINFO) from inception until September 2025. Randomized controlled trials reporting on the effects of intravenous ketamine to treat PTSD were included.
Results: Seven studies with a total of 323 participants were included in this review. Ketamine administration meaningfully improved PTSD symptoms in two trials as evidenced by significant improvement on the Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5) and the Impact of Event Scale‐Revised (IES‐R) compared to control/placebo. Multi‐infusion administration schedules achieved greater clinical outcomes when compared to single‐dose administration schedules. Preliminary evidence suggests that repeated lower doses (0.2mg/kg) of ketamine were more efficacious in sustaining treatment effects than standard doses (0.5mg/kg). For persons receiving ketamine, an association was observed between top‐down inhibition of the amygdala originating in the ventromedial prefrontal cortex (vmPFC) and symptom improvement.
Conclusion: Our results suggest that intravenous ketamine may be efficacious in the treatment of PTSD. Subsequent studies should attempt to evaluate the additive effect of combining ketamine with psychotherapeutic interventions as well as determining mechanistic pathways mediating symptom relief in persons with PTSD.