Clinical Outcomes of Ketamine Therapy for Depression, Anxiety, and PTSD in Post-TBI Patients
European Psychiatry June 1, 2026 DOI: 10.1192/j.eurpsy.2026.11400 (opens in new tab)
Summary
AI-generated from the abstractA retrospective chart review of 35 adults with traumatic brain injury (TBI) and treatment-resistant depression and PTSD found that ketamine, administered via intramuscular injection, intranasal esketamine, or oral dissolving tablets, was associated with large reductions in depression, anxiety, and PTSD symptoms. Response rates reached 72% and remission 45%, with initial improvement within 5-10 days. Parenteral routes (IM and intranasal) outperformed oral due to better bioavailability. Adverse events were mild and transient, suggesting ketamine may be a viable option for this population.
Study at a glance
| Characteristics | Retrospective chart review Peer reviewed |
|---|---|
| Sample size | 35 |
| Population | Adult TBI patients with depression and PTSD |
| Dose | IM 0.5-0.75 mg/kg; intranasal 84 mg; oral 100-300 mg |
| Key finding | Ketamine treatment was associated with large effect sizes (32.7% to 65.6% symptom reduction) and 72% response and 45% remission rates in TBI patients, with parenteral routes outperforming oral. |
Abstract
Introduction TBI patients often suffer from severe, treatment-resistant depression and PTSD. Ketamine shows promise in non-TBI populations, but its efficacy in TBI patients needs exploration for efficacy and tolerability. Objectives Evaluate ketamine’s clinical effectiveness and safety (PHQ-9, GAD-7, PCL-5 scores) in post-TBI patients, comparing IM, intranasal, and oral routes. Methods Design: Retrospective chart review of 35 adult TBI patients (mean age 38.4; TBI 3.5 years prior). Formulations: IM (0.5-0.75 mg/kg), Intranasal (84 mg esketamine), and Oral Dissolving Tablets (100-300 mg). Measures: PHQ-9, GAD-7, and PCL-5 scores. Analysis: Efficacy by % reduction, response (≥50% reduction), and remission (PHQ-9 < 5, PCL-5 < 20). Results Magnitude: Large effect sizes observed (32.7% GAD-7/ODT to 65.6% PCL-5/Nasal). Clinical: 72% response, 45% remission rates. Route-Dependent: Parenteral (IM/Nasal) outperformed ODT due to better bioavailability. Rapid Onset: Initial improvement within 5-10 days. Safety: Favorable profile with mild, transient adverse events. Conclusions Magnitude: Large effect sizes observed (32.7% GAD-7/ODT to 65.6% PCL-5/Nasal). Clinical: 72% response, 45% remission rates. Route-Dependent: Parenteral (IM/Nasal) outperformed ODT due to better bioavailability. Rapid Onset: Initial improvement within 5-10 days. Safety: Favorable profile with mild, transient adverse events. 1. Directions Disclosure of Interest None Declared