Intravenous Ketamine Exacerbating Symptoms of Acute Stress Disorder: A Case Report and Systematized Review of Existing Literature.
Charalambia Louka, Stephanie Chiao
Journal of the Academy of Consultation-Liaison Psychiatry November 1, 2023 DOI: 10.1016/j.jaclp.2023.11.687 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report with literature review Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 26-year-old man with gunshot wounds who developed acute stress disorder |
| Intervention | Ketamine |
| Topics | Esketamine Ketamine |
| Key findings | The authors report that a 26-year-old man's acute stress disorder worsened after analgesic ketamine, and their review found ketamine was associated with worsened ASD symptoms in 2 of 3 articles. Among 6 articles on PTSD, 1 found increased incidence or severity, 2 found decreased incidence or severity, and 3 found no relationship. They conclude ketamine's psychotomimetic properties may exacerbate dissociative and perceptual ASD symptoms, but long-term PTSD effects remain unclear. |
Abstract
Background: Ketamine is an anesthetic and analgesic known for its psychotomimetic properties, such as dissociation and altered perception. Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are characterized by unwanted memories, intrusive thoughts, and dissociative flashbacks following an acute traumatic event. It is unknown how analgesic ketamine affects the symptomatology of ASD when administered to patients in the post-traumatic period. OBJECTIVE & METHODS In this article, we present the case of a 26 year-old man who sustained gunshot wounds and developed worsened ASD after receiving analgesic ketamine. We also present a review of the current literature on peritraumatic ketamine and its subsequent effect on ASD and PTSD.
Results: In 2 out of 3 articles examining ketamine and ASD, ketamine was associated with worsened symptomatology of ASD. There were 6 articles examining ketamine and PTSD. In 1 of 6 articles, ketamine was associated with increased incidence and/or severity of PTSD and in 2 of 6, it was associated with decreased incidence and/or severity of PTSD. There was no relationship between ketamine and subsequent PTSD in 3 out of 6 articles.
Conclusion: We conclude that ketamine's psychotomimetic properties may exacerbate the dissociative and perceptual symptoms of ASD, but its long-term effects on PTSD are still unclear. In patients with preexisting ASD, the potential risks and benefits of using analgesic ketamine must be weighed carefully.