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.
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 |
| Molecular pathways of ketamine: A systematic review of immediate and sustained effects on PTSD. | 2025 | Systematic review | |
| Ketamine in the effective management of chronic pain, depression, and posttraumatic stress disorder for Veterans: A meta-analysis and systematic review. Military populations (active-duty and Veterans) | 2024 | Meta-analysis and 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 11
- Ketamine and its two enantiomers in anesthesiology and psychiatry: A historical review and future directions Journal of Anesthesia and Translational Medicine July 11, 2024
- The ketamine chameleon: history, pharmacology, and the contested value of experience. Expert Review of Clinical Pharmacology March 1, 2025
- Effects of ketamine on fear memory extinction: a review of preclinical literature. Frontiers in Neuroscience 2025
- The evidence for ketamine treatment in older adults with psychiatric illness: a scoping review Therapeutic Advances in Chronic Disease October 1, 2025
- Reconnecting through dissociation: a 5-month follow-up case study on ketamine-assisted psychotherapy for anorexia nervosa. Journal of Eating Disorders June 10, 2025
and 6 more in the library
Cites 17
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- A Randomized Add-on Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Bipolar Depression Archives of General Psychiatry August 1, 2010
- Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder JAMA Psychiatry April 16, 2014
- A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. American Journal of Psychiatry January 5, 2021
- Ketamine Safety and Tolerability in Clinical Trials for Treatment-Resistant Depression The Journal of Clinical Psychiatry September 2, 2014
and 12 more in the library