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SLOW BUT STEADY: ORAL KETAMINE AS AN EFFECTIVE ADJUNCT IN DEPRESSION, ANXIETY AND PTSD

*William Sulis

International Journal of Neuropsychopharmacology February 12, 2025 DOI: 10.1093/ijnp/pyae059.084 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Pilot study Peer reviewed
Sample size 8
Population Patients with PTSD, suicidality, treatment-resistant depression, or anxiety
Intervention Oral ketamine
Dose 5 mg/kg
Duration 12 treatments; follow-up nearly 18 months
Topics Anxiety Depression Esketamine Ketamine PTSD
Key points During the 12-treatment administration phase, response was minimal to modest, but over subsequent weeks seven of eight patients experienced significant improvement in symptom severity and daily function that persisted for nearly 18 months of follow-up. Oral ketamine was well tolerated, with mild to moderate hypertension and drowsiness as the main side effects. The author proposes that oral ketamine warrants further study as a possible adjunctive treatment in resistant cases.

Abstract

Abstract Intravenous and intranasal Ketamine have become important options for the rapid relief of symptoms in PTSD, Suicidality and in Treatment Resistant Depression and Anxiety. However, they are costly, require at least an out- patient clinic setting and have relatively short lived benefits. I present a pilot study examining 8 patients treated with oral Ketamine, 5 mg/kg for 12 treatments. Treatment was well tolerated with mild to moderate hypertension and drowsiness the main side effects. Treatment response during the administration phase was minimal to modest at best. Nevertheless over subsequent weeks, 7 subjects experienced significant improvement in symptom severity and daily function which has persisted for nearly 18 months in follow up. One subject dropped out. Oral Ketamine warrants further study as a possible adjunctive treatment in resistant cases.

Comparable studies

Other non-randomized and open-label trials on ketamine for PTSD, most cited first.

Study Year Design Participants
Efficacy and Safety of Intranasal Esketamine in Patients With Treatment-Resistant Depression and Comorbid Chronic Post-traumatic Stress Disorder: Open-Label Single-Arm Pilot Study Patients with treatment-resistant major depressive disorder and comorbid post-traumatic... 2022 Open-label, single-arm, retrospective pilot study n = 11
Six weeks open-label oral ketamine for patients with treatment-resistant depression, post-traumatic stress disorder, or obsessive-compulsive disorder. Participants with treatment-resistant depression (TR-D), post-traumatic stress disorder... 2025 Open-label extension study n = 43
Ketamine for treatment-resistant post-traumatic stress disorder: double-blind active-controlled randomised crossover study Community sample of individuals with PTSD 2025 Clinical trial
Clinical indicators of the suicide crisis and response to ketamine. Adults across the continuum of suicide risk, including 14 high-risk individuals who had... 2025 Observational cohort with open-label intervention n = 118
Ketamine-assisted psychotherapy provides lasting and effective results in the treatment of depression, anxiety and post traumatic stress disorder at 3 and 6 months: Findings from a large single-arm retrospective effectiveness trial Adults with a history of depression, anxiety, or PTSD who had not responded to prior... 2023 Retrospective single-arm effectiveness trial n = 1,806

Related reading

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Anxiety Depression Esketamine Ketamine PTSD

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