Treating Post-Traumatic Stress Disorder in Canadian Special Operation Forces Command With Ketamine Plus Cervical Sympathetic Blockade.

Canadian special operations forces with PTSD and blast-related brain injuries received four combined ketamine infusions and bilateral cervical sympathetic blocks. Two weeks after treatment, average PTSD symptom scores dropped by 45 points, and among those with a history of traumatic brain injury, neurobehavioral symptoms decreased by 87%. This combined approach may offer a clinically meaningful reduction in symptoms for this high-risk group, though the small sample and lack of a control group limit the findings.

Study at a glance

Abstract

Canadian Special Operation Forces Command (CANSOFCOM) operators have been extensively deployed in recent conflicts. They are at risk of trauma and blast exposure as well as the development of post-traumatic stress disorder (PTSD) and blast traumatic brain injury (bTBI). Current psychotherapy and pharmacological approaches provide suboptimal resolution of PTSD and bTBI symptoms. Prior research has shown that ketamine infusion and cervical sympathetic blockade (CSB) have reduced PTSD and bTBI symptoms. A total of 11 patients, including CANSOFCOM members, were treated and followed. Pre- and post-intervention PTSD Checklist-5 and Neurobehavioral Inventory Scale (NSI) scores were recorded. Neurobehavioral Inventory Scale questionnaire was administered only to patients with a history of traumatic brain injury. Each patient received 4 ketamine infusion and bilateral CSB treatments, as per previously published by IRB protocol #00000971. Two weeks post-intervention, average PTSD Checklist score reduction of 45.09 (n = 11). Two weeks post-intervention, average NSI score reduction of 40.7 (87.0% reduction) (n = 6). No other NSI scores were available. These findings highlight the importance of early intervention and ongoing evaluation in PTSD treatment. Ketamine infusion combined with bilateral CSB can provide a clinically significant reduction of PTSD and bTBI in the CANSOFCOM cohort. Of interest, another study of CSB alone as a treatment of bTBI, which used NSI assessment, showed a reduction of 53% on a 1-month follow-up. Our report demonstrated an 87% reduction in NSI score at 2 weeks. Possible physiological explanations and study limitations are discussed.