Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression.
Christina Sophia Albott, Kelvin O Lim, Miriam K Forbes, Christopher R Erbes, Susanna J Tye, John G Grabowski, Paul Thuras, Tegan M Batres-Y-Carr, Joseph Wels, Paulo R Shiroma
The Journal of Clinical Psychiatry 2018 DOI: 10.4088/jcp.17m11634 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label clinical trial Peer reviewed |
|---|---|
| Sample size | 15 |
| Population | Veterans with comorbid DSM-5 PTSD and DSM-IV major depressive disorder (treatment-resistant depression) |
| Intervention | Ketamine |
| Dose | 0.5 mg/kg |
| Duration | 6 infusions over 12 days, with 8 weeks of follow-up after the final infusion |
| Measures | PTSD Checklist for DSM-5, Montgomery-Asberg Depression Rating Scale |
| Topics | Depression Esketamine Ketamine PTSD |
| Registration | NCT02577250 |
| Key findings | Repeated intravenous ketamine infusions produced rapid, large reductions in PTSD and depression symptoms, with 80.0% of participants in PTSD remission and 93.3% responding for depression, but median time to relapse was 41 days for PTSD and 20 days for depression. The authors suggest ketamine is safe and may be efficacious for comorbid PTSD and treatment-resistant depression. |
Abstract
The present study examined the efficacy, safety, and durability of repeated ketamine infusions for the treatment of comorbid posttraumatic stress disorder (PTSD) and treatment-resistant depression (TRD) in a sample of veterans. Individuals with comorbid DSM-5-defined PTSD and DSM-IV-defined major depressive disorder (N = 15) received 6 intravenous ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period from May 2015 to June 2016. Data from outcome measures were collected before and 24 hours after each infusion and weekly for 8 weeks following the final infusion. Continuous measures of symptom change were significant for both disorders and were associated with large effect sizes (mean decrease in PTSD Checklist for DSM-5 score = 33.3 points [95% CI, 23.0-43.5 points], P < .0005, sample size-adjusted Cohen d [d'] = 2.17; mean decrease in Montgomery-Asberg Depression Rating Scale score = 26.6 points [95% CI, 23.0-30.2 points], P < .0005, d' = 4.64). The remission rate for PTSD was 80.0%, and the response rate for TRD was 93.3%. Participants in remission from PTSD after the infusion series (n = 12) had a median time to relapse of 41 days. Similarly, participants whose depression symptoms responded to the infusion series (n = 14) had a median time to relapse of 20 days. Repeated ketamine infusions were associated with transient increases in dissociative symptoms. No participant reported worsening of PTSD symptoms over the study duration. This study, the first open-label study of repeated ketamine infusions in a comorbid population, found rapid and sustained improvement in PTSD and depression symptoms. This report suggests that repeated ketamine treatments are safe and may represent an efficacious treatment for individuals with comorbid PTSD and TRD. ClinicalTrials.gov identifier: NCT02577250.
Comparable studies
Other non-randomized and open-label trials on ketamine for PTSD, most cited first.
Citations in the library
Cited by 79
- Reviewing the Potential of Psychedelics for the Treatment of PTSD The International Journal of Neuropsychopharmacology March 12, 2020
- A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. American Journal of Psychiatry January 5, 2021
- Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms Pharmacological Reviews December 16, 2020
- Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers Therapeutic Advances in Psychopharmacology 2020
- Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Current Neuropharmacology 2024
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