Clinical Outcomes of Ketamine Therapy for Depression, Anxiety, and PTSD in Post-TBI Patients
W. Aldulaimy, A. Shah
European Psychiatry June 1, 2026 DOI: 10.1192/j.eurpsy.2026.11400 (opens in new tab)
Study at a glance
AI-extracted from the abstract| 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 esketamine; Oral: 100-300 mg |
| Measures | PHQ-9, GAD-7, PCL-5 |
| Topics | Anxiety Depression Esketamine Ketamine PTSD |
| Key findings | 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.
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
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Ketamine treatment was associated with large effect sizes (32.7% to 65.6% symptom reduction) and 72% response and 45% remission rates, with parenteral routes outperforming oral.
Synthesized
Comparable studies
Other observational and cohort studies on ketamine for PTSD, most cited first.