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High-Dose Ketamine Infusion for the Treatment of Posttraumatic Stress Disorder in Combat Veterans

C. Ross, R. Jain, Carl J. Bonnett, Philip E. Wolfson

Annals of Clinical Psychiatry November 1, 2019 DOI: 10.1177/154733251903100411 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational study Peer reviewed
Sample size 30
Population US military veterans with combat-related PTSD
Intervention Ketamine
Duration Six 1-hour ketamine infusions, with questionnaires before the first and sixth infusions
Measures Patient Health Questionnaire, PTSD Checklist for DSM-5
Topics Esketamine Ketamine PTSD
Key findings In 30 veterans with combat-related PTSD, six ketamine infusions were followed by significant drops in depression scores (18.9 to 9.5) and PTSD Checklist for DSM-5 scores (56.2 to 31.3), while self-reported substance use did not significantly decrease though it trended down. The authors suggest high-dose ketamine infusion therapy could be a valuable treatment for combat-related PTSD and call for further study of its mechanism.

Abstract

Introduction: Combat veterans are at high risk for the development of posttraumatic stress disorder (PTSD) and substance use disorders. Ketamine has been shown to be an effective treatment for numerous mental health disorders, although research on its efficacy in combat-related PTSD in veterans is very limited.

Methods: The study population consisted of 30 US military veterans with combat-related PTSD. Participants underwent a standard induction series of six 1-hour ketamine infusions with the goal of obtaining a transpersonal dissociative experience. Participants were given a series of self-report questionnaires to assess for changes in symptoms of depression, PTSD, and substance use prior to the first and sixth infusions.

Results: Symptoms of depression as measured by change in score on the Patient Health Questionnaire decreased significantly from an average of 18.9 to 9.5 (P < .001). Similarly, symptoms of PTSD as measured by change in score on the PSTD Checklist for DSM-5 dropped significantly from an average of 56.2 to 31.3 (P < .001). Self-reported levels of substance use did not significantly decrease during the study period, although the level of use trended down.

Conclusions: This observational study suggests that high-dose ketamine infusion therapy, which induced a transpersonal dissociative experience, could be a valuable tool in the treatment of combat-related PTSD. Further study is needed to better elucidate ketamine's mechanism of action with regards to the treatment of PTSD.

Comparable studies

Other observational and cohort studies on ketamine for PTSD, most cited first.

Study Year Design Participants
Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD 2018 Retrospective review n = 37
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 Retrospective Effectiveness Study. Adults with a history of major depressive disorder, generalized anxiety disorder, or... 2024 Retrospective effectiveness study n = 346
Combined ketamine and psychotherapy provide no additional benefit beyond ketamine alone in treating depression or PTSD: Evidence from a help-seeking sample. Help-seeking individuals with depression and/or PTSD 2025 Observational cohort n = 624
Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm. Outpatients with elevated PTSD Checklist for DSM-5 scores 2025 Retrospective study n = 117
Ketamine treatment effects on DNA methylation and Epigenetic Biomarkers of aging Individuals with major depressive disorder or posttraumatic stress disorder 2024 Observational cohort n = 20

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