Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis.
Thales Marcon Almeida, Ursula Raianny Lacerda da Silva, Jeully Pereira Pires, Isaac Neri Borges, Clara Rosa Muniz Martins, Quirino Cordeiro, Ricardo R Uchida
Clinical neuropsychiatry February 1, 2024 DOI: 10.36131/cnfioritieditore20240102 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Population | Adults with post-traumatic stress disorder |
| Intervention | Ketamine |
| Duration | 1 to 4 weeks |
| Topics | Ketamine PTSD Esketamine |
| Keywords | Meta-analysis Systematic review Mental health PTSD Treatment Ketamine therapy Clinical research Drug therapy |
| Citations | 20 |
| Key findings | Ketamine significantly improved PTSD symptoms at the end of treatment courses lasting one to four weeks, but not 24 hours after the first infusion, with a standardized effect size of 0.25. |
Abstract
Post-traumatic stress disorder (PTSD) is an enduring condition characterized by a chronic course and impairments across several areas. Despite its significance, treatment options remain limited, and remission rates are often low. Ketamine has demonstrated antidepressant properties and appears to be a promising agent in the management of PTSD. A systematic review was conducted in PubMed/MEDLINE, Cochrane Library, Clinicaltrials.gov, Lilacs, Scopus, and Embase, covering studies published between 2012 and December 2022 to assess the effectiveness of ketamine in the treatment of PTSD. Ten studies, consisting of five RCTs, two crossover trials, and three non-randomized trials, were included in the meta-analysis. Ketamine demonstrated significant improvements in PCL-5 scores, both 24 hours after the initial infusion and at the endpoint of the treatment course, which varied between 1 to 4 weeks in each study. Notably, the significance of these differences was assessed using the Two Sample T-test with pooled variance and the Two Sample Welch's T-test, revealing a statistically significant effect for ketamine solely at the endpoint of the treatment course (standardized effect size= 0.25; test power 0.9916; 95% CI = 0.57 to 17.02, p=0.0363). It is important to note that high heterogeneity was observed across all analyses. Our findings suggest that ketamine holds promise as an effective treatment option for PTSD. However, further trials are imperative to establish robust data for this intervention.