Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review.
Jenny J W Liu, Natalie Ein, Julia Gervasio, Clara Baker, Rachel Plouffe, Sonya Wanklyn, Amer M. Burhan, Brenda Lau, Emmanuel Abreu, Thomas Wasiuta, Anthony Nazarov, J Don Richardson
Frontiers in Psychiatry 2024 DOI: 10.3389/fpsyt.2024.1338581 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis and systematic review Peer reviewed |
|---|---|
| Population | Military populations (active-duty and Veterans) |
| Intervention | Ketamine |
| Topics | Depression Ketamine PTSD Esketamine |
| Keywords | Mental health Veterans-military-servicemembers Mental-Health-PTSD-Depression-Trauma Ketamine-therapy-treatment Chronic-pain-pain-management Medical-research-clinical-studies |
| Citations | 13 |
| Key findings | Ketamine use was associated with significant reductions in pain, depression, and PTSD symptoms in military populations, with moderate-to-large effect sizes. |
Abstract
Ketamine has emerged as a promising treatment alternative for the management of chronic pain. Despite encouraging findings in civilian populations, and favourable results from trials examining its efficacy in military populations, there is still a dearth of information pointing to optimal specifications related to ketamine administration for pain, depression, and posttraumatic stress disorder (PTSD) in military populations. This meta-analysis and systematic review synthesised available evidence on the effectiveness, tolerability, and feasibility of ketamine in the management of chronic pain and mental health conditions in military populations. This review followed the Cochrane's Guide for systematic reviews of interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) as frameworks for data collection and synthesis. A total of 11 studies and 22 independent samples were retained for data analyses. Across samples, improvements in pain, depression, and PTSD outcomes were evident, with the use of ketamine leading to significant reductions, g = 1.76, SE = 0.19, 95% CI (1.39, 2.13), Z = 9.26, p <.001. These effect sizes were robust with moderate-to-large effects. In addition, the reductions in symptoms were observed in both active-duty and Veteran groups, and for different routes of ketamine administration, frequencies of ketamine administration, duration of ketamine treatments, dosage, study design, and allowance for concurrent treatments. This review provides a preliminary synthesis of available evidence which suggests that ketamine may be a potential option for the treatment of depression, PTSD, and chronic pain in military populations. The viability of ketamine as an alternative treatment may be particularly impactful for those who are treatment resistant, experience chronic symptoms, and/or have exhausted conventional treatments. More research is warranted in order verify the findings presented in this review.
Comparable studies
Other systematic reviews and meta-analyses on ketamine for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin Adults with PTSD | 2020 | Systematic review | n = 9 |
| The Multivariate Effect of Ketamine on PTSD: Systematic Review and Meta-Analysis Soldiers with combat experience, including wounded or burn soldiers | 2022 | Meta-analysis | n = 503 |
| Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis. Adults with post-traumatic stress disorder | 2024 | Systematic review and meta-analysis | |
| Molecular pathways of ketamine: A systematic review of immediate and sustained effects on PTSD. | 2025 | Systematic review | |
| The Induction of Dissociative States: A Meta-Analysis. Individuals from clinical and nonclinical samples | 2025 | Meta-analysis | n = 6,692 |
Citations in the library
Cited by 7
- Managing Chronic Pain: The Ketamine Option CNS Drugs October 16, 2025
- Ketamine-assisted group psychotherapy integrating cognitive processing therapy to address identity-based trauma: a pilot study Frontiers in Psychiatry January 22, 2026
- Ketamine-Assisted Therapy Outcomes for First Responders With Comorbid Mental Health Diagnoses Journal of Occupational and Environmental Medicine October 17, 2025
- Classic Psychedelics for Chronic Pain: A Critical Review of the Literature and Practical Advice for Clinicians. Drugs June 4, 2026
- How ketamine works: An actionable hypothesis. Proceedings of the National Academy of Sciences May 5, 2026
and 2 more in the library
Cites 13
- Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder JAMA Psychiatry April 16, 2014
- Ketamine for chronic pain: risks and benefits British Journal of Clinical Pharmacology February 21, 2013
- Ketamine for Depression, 4: In What Dose, at What Rate, by What Route, for How Long, and at What Frequency? The Journal of Clinical Psychiatry July 20, 2017
- Randomized trial of ketamine masked by surgical anesthesia in patients with depression Nature Mental Health October 19, 2023
- International pooled patient-level meta-analysis of ketamine infusion for depression: In search of clinical moderators Molecular Psychiatry September 7, 2022
and 8 more in the library