Skip to content

Ketamine for PTSD

Studies whose primary subject is both Ketamine and PTSD, with an evidence synthesis read across the most-cited and most recent of them.

State of the evidence

Synthesized

Synthesized from 24 studies in the library · AI-generated, grounded in the abstracts below

Found by searching the library for Ketamine, racemic ketamine, arketamine, R-ketamine, PTSD, post-traumatic stress disorder, then ranked by relevance.

Ketamine shows consistent short-term benefit for chronic PTSD: randomized trials report rapid symptom reduction versus active placebo, with large effects after repeated infusions, and observational and review evidence generally points the same way. However, the evidence base is small (most trials 20-41 participants), heterogeneous in dosing, route, and co-therapy, and rated low to very low quality in systematic reviews; durability beyond a few weeks is largely unestablished. One meta-analysis in combat soldiers found no reduction in PTSD incidence and possible worsening of early PTSD, suggesting timing and population matter.

Evidence by study

Direction is which way each study's own result points, not our rating of the study. All 25 matching studies were reviewed; the 24 that directly address the question are shown here.

What the directions mean
Supports:
the study found the intervention worked, or its hypothesis held.
Opposes:
it found the opposite, no benefit or a harm.
No effect:
no significant difference either way.
Mixed:
effects in both directions within the same study.
Unclear:
the abstract does not report a direction.
Study Design Sample size Direction Finding
Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder 2014 RCT (double-blind crossover) 41 Supports A single 0.5 mg/kg ketamine infusion produced significantly greater reduction in PTSD symptom severity at 24 hours than midazolam.
A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. 2021 RCT 30 Supports Six ketamine infusions over two weeks produced significantly greater improvement in CAPS-5 and depression scores than midazolam, with a large effect size and 67% responder rate at two weeks.
Long term structural and functional neural changes following a single infusion of Ketamine in PTSD 2023 randomized controlled pilot trial 27 Mixed PTSD symptoms improved equally in ketamine and midazolam groups, but ketamine recipients showed lower amygdala reactivation and altered connectivity to trauma memories, which the authors propose may reflect enhanced fear-memory modulation.
d-Serine is a potential biomarker for clinical response in treatment of post-traumatic stress disorder using (R,S)-ketamine infusion and TIMBER psychotherapy: A pilot study. 2018 pilot randomized placebo-controlled study 20 Supports Adding mindfulness-based therapy to a single subanesthetic ketamine dose produced a longer duration of therapeutic response than therapy plus placebo (about 34 vs 17 days).
Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. 2018 retrospective review 37 Supports Oral ketamine was associated with large reductions in inpatient hospital days and psychiatric admissions, with no serious adverse events or tolerance reported.
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series 2022 retrospective case series 35 Supports Repeated intranasal (S)-ketamine was associated with improvements in both depression and PTSD symptoms, with PTSD effects appearing temporally distinct from depression effects.
A Cohort-Based Case Report: The Impact of Ketamine-Assisted Therapy Embedded in a Community of Practice Framework for Healthcare Providers With PTSD and Depression 2022 quality improvement evaluation (mixed methods) 94 Supports A ketamine-assisted psychotherapy program in a community-of-practice model was associated with clinically significant improvements in PTSD, depression, anxiety, and work/life functioning.
Blood biomarker changes in response to low-dose oral ketamine treatment in adults with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) 2026 observational cohort 35 Supports Low-dose oral ketamine was associated with improvements in depression, anxiety, stress, and PTSD symptoms, with similar biological response in MDD and MDD+PTSD groups.
At-Home Telehealth-Supported Subcutaneous Ketamine Therapy in Adults With Moderate to Severe Depression, Anxiety, or PTSD: A Real-World Observational Study of Safety, Feasibility, and Clinical Outcomes in a Large, Heterogeneous Cohort in the United States. 2026 retrospective observational study 3870 Supports At-home subcutaneous ketamine was associated with large, clinically meaningful reductions in depression, anxiety, and PTSD symptoms with low adverse events.
Effect of esketamine-assisted regional block on post-traumatic stress disorder after radical lung cancer surgery: A retrospective clinical study 2026 retrospective cohort 218 Supports Esketamine-assisted regional block was associated with lower postoperative PTSD prevalence at three months (19.6% vs 37.7%) and lower cortisol and IL-6 levels.
Ketamine effects on EEG and their links to therapy differ across treatment-resistant major depression, post-traumatic stress disorder, and obsessive-compulsive disorder 2026 within-subjects placebo-controlled experiment 42 Mixed Ketamine's EEG effects and their correlation with symptom improvement differed by diagnosis, with treatment-resistant PTSD showing dose-dependent alpha changes not seen in MDD.
Ketamine-assisted psychotherapy for posttraumatic stress disorder: a systematic review and individual participant data meta-analysis of predictors of treatment effects. 2026 systematic review and individual participant data meta-analysis 533 Supports Across 12 studies of combined ketamine and psychotherapy, higher baseline PTSD severity, more psychotherapy and ketamine sessions, and shorter treatment duration predicted greater symptom improvement.
The Multivariate Effect of Ketamine on PTSD: Systematic Review and Meta-Analysis 2022 meta-analysis 503 Mixed Ketamine did not significantly reduce PTSD incidence (RR 0.81) and was associated with worsening of early PTSD (RR 2.45), but was associated with improvement in chronic PTSD scores.
Efficacy of Psychoactive Drugs for the Treatment of Posttraumatic Stress Disorder: A Systematic Review of MDMA, Ketamine, LSD and Psilocybin 2020 systematic review 9 Mixed Ketamine as a stand-alone treatment for comorbid PTSD and depression was rated very low quality evidence, and ketamine plus psychotherapy low quality, versus moderate for MDMA plus psychotherapy.
Efficacy and safety of ketamine for post‐traumatic stress disorder: A systematic review with narrative synthesis and consideration of military and veteran populations 2026 systematic review 383 Supports Most of eight included studies reported short-term PTSD symptom reductions after ketamine or esketamine, but the largest effect came from a small uncontrolled study and the authors call the evidence preliminary.
The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence. 2023 review Supports Synthesizing case reports through randomized trials, the authors report encouraging signals of ketamine safety, efficacy, and durability for PTSD amid high clinical heterogeneity.
The Psychedelic Future of Post-Traumatic Stress Disorder Treatment 2024 review Supports Reviews psychedelic interventions including ketamine and reports that initial trials show potential value for PTSD while standard treatments leave many patients symptomatic.
Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation. 2022 review Supports Reports early evidence for psychedelics including ketamine in PTSD, framed around memory reconsolidation mechanisms, while noting large-scale trials are needed.
Psychedelic Therapies in the Management of Post-Traumatic Stress Disorder 2026 review Supports Reports that ketamine offers rapid symptom alleviation, notably for treatment-resistant cases with high self-harm and suicide risk.
Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. 2024 narrative review Unclear Describes chronic PTSD as a systemic disorder with suboptimal response to existing treatments, motivating novel approaches including psychedelics.
Glutamate and post-traumatic stress disorder: toward a psychobiology of dissociation. 1999 review Unclear Argues that stress-induced glutamate release and NMDA antagonist effects may contribute to dissociation in PTSD, and that drugs reducing glutamate release warrant study in traumatized individuals.
Ketamine administration reduced conditioned defensive behaviour and upregulated protein expression associated with neuroplasticity in a planarian model of aversive memory reactivation. 2026 preclinical experimental study 15 Supports In planaria undergoing aversive memory reactivation, 10 μM ketamine reduced defensive behaviors and was associated with protein pathways linked to synaptic plasticity.
Acute pretrauma ethanol exacerbates PTSD-like phenotype in rats and is reversed by early intranasal ketamine 2026 preclinical experiment Supports Early post-trauma intranasal ketamine reduced PTSD-like phenotypes and hippocampal dendritic changes in rats pretreated with ethanol before stress.
Multi-center, randomized controlled efficacy and comparative-effectiveness study evaluating ketamine, stellate ganglion blocks, combination treatment, and sham treatments for posttraumatic stress disorder and traumatic brain injury-associated headache: a study protocol 2026 RCT protocol 210 Unclear Protocol for a multicenter double-blind trial comparing ketamine, stellate ganglion block, combination, and placebo/sham on headache and PTSD outcomes at 4 weeks.

Points of agreement

  • Randomized trials with active placebo report rapid short-term PTSD symptom reduction from ketamine.
  • Repeated infusions and combination with psychotherapy are associated with larger or longer-lasting benefit.
  • Observational and open-label studies consistently report symptom improvement across IV, intranasal, oral, and subcutaneous routes.
  • Reviews agree that existing PTSD treatments leave many patients symptomatic, motivating ketamine research.
  • Adverse effects during infusion (dissociative, hemodynamic) are common but typically transient.

Conflicts

  • One meta-analysis found no reduction in PTSD incidence and possible worsening of early PTSD in soldiers, while other trials report benefit in chronic PTSD.
  • One randomized pilot found PTSD symptoms improved equally with ketamine and midazolam, despite neural differences.
  • Systematic reviews rate the certainty of ketamine evidence as low to very low, contrasting with the encouraging tone of narrative reviews.

Gaps

  • Durability of benefit beyond a few weeks is largely unestablished.
  • Most randomized trials are small (20-41 participants) and single-site.
  • Optimal dose, route, number of sessions, and role of concurrent psychotherapy are unresolved.
  • Blinding is difficult with psychoactive placebo and dissociative effects.
  • Military/veteran and early-intervention populations show inconsistent results.
  • Long-term safety and cognitive effects of repeated dosing are under-studied.
Browse these studies in the library

Common questions

What does the research agree on about ketamine for PTSD?
  • Randomized trials with active placebo report rapid short-term PTSD symptom reduction from ketamine.
  • Repeated infusions and combination with psychotherapy are associated with larger or longer-lasting benefit.
  • Observational and open-label studies consistently report symptom improvement across IV, intranasal, oral, and subcutaneous routes.
  • Reviews agree that existing PTSD treatments leave many patients symptomatic, motivating ketamine research.
  • Adverse effects during infusion (dissociative, hemodynamic) are common but typically transient.
Where do studies on ketamine for PTSD conflict?
  • One meta-analysis found no reduction in PTSD incidence and possible worsening of early PTSD in soldiers, while other trials report benefit in chronic PTSD.
  • One randomized pilot found PTSD symptoms improved equally with ketamine and midazolam, despite neural differences.
  • Systematic reviews rate the certainty of ketamine evidence as low to very low, contrasting with the encouraging tone of narrative reviews.
What is still unknown about ketamine for PTSD?
  • Durability of benefit beyond a few weeks is largely unestablished.
  • Most randomized trials are small (20-41 participants) and single-site.
  • Optimal dose, route, number of sessions, and role of concurrent psychotherapy are unresolved.
  • Blinding is difficult with psychoactive placebo and dissociative effects.
  • Military/veteran and early-intervention populations show inconsistent results.
  • Long-term safety and cognitive effects of repeated dosing are under-studied.
How we analyze this

This synthesis reads the 15 most-cited and 10 most recent studies whose primary subject is Ketamine for PTSD, up to 25 in all. The most-cited set anchors the established evidence, and the recent set surfaces work that is too new to have gathered citations yet.

A study qualifies only when Ketamine for PTSD or a known alias appears in its title or keywords, so broad reviews that mention it only in passing are left out. Each study is read from its abstract, strongest evidence first, and the summary reports the direction of the results along with any conflicts and gaps.

The full method, including what a person does and does not review, is on the methods page.

Ask your own question in the Research Synthesis Tool

130 articles · 67 from the last two years · 32,418 participants across 77 studies reporting sample size

Common study designs

review 14 case study 5 animal study 6 systematic review 8 observational cohort 7

Research volume by year

Compare topics →

125 studies whose primary subject is ketamine for PTSD since 2005

Studies about ketamine for PTSD per year, 2005 to 2026, peaking at 37 in 2025 Bar chart: one bar per year, taller where more studies were published that year. 0 20 40 2005 2010 2015 2020 2025
2026 is partial
Show the numbers
Studies about ketamine for PTSD per year, 2005 to 2026, peaking at 37 in 2025
Year Studies
2005 1
2006 0
2007 0
2008 0
2009 0
2010 0
2011 0
2012 0
2013 0
2014 1
2015 0
2016 0
2017 3
2018 6
2019 2
2020 2
2021 6
2022 13
2023 8
2024 19
2025 37
2026 27

Research

Synthesize the evidence →

Virtual reality therapy is a feasible and tolerable adjunct to ketamine treatment for PTSD and depression

Discover Mental Health October 27, 2026 Safa Rubaye, Aditya Shah, Waleed Aldulaimy et al.

Ketamine is an important intervention for severe depression and trauma-related psychopathology, but the optimal way to provide therapeutic support during treatment remains unclear. Although ketamine-assisted psychotherapy is clinically appealing, maintaining therapist presence throughout every dosing session can be logistically difficult. Virtual reality (VR) may offer a structured, scalable,...

DOI: 10.1007/s44192-026-00643-w (opens in new tab)

Ketamine administration reduced conditioned defensive behaviour and upregulated protein expression associated with neuroplasticity in a planarian model of aversive memory reactivation.

Progress in neuro-psychopharmacology & biological psychiatry October 17, 2026 Fionnghuala L J James, Sayed K Ahamed, Cheng-I Yang et al.

Traumatic memories that are resistant to modification or extinction are a characteristic feature of post-traumatic stress disorder (PTSD). The process of fear memory reconsolidation has been identified as a potential therapeutic target for the treatment of PTSD. Ketamine, an NMDA receptor antagonist with dissociative properties, has been identified as a drug with high therapeutic potential for...

DOI: 10.1016/j.pnpbp.2026.111979 (opens in new tab) Full text (opens in new tab) Ketamine Neuroplasticity PTSD Planaria +2

Efficacy and safety of ketamine for post‐traumatic stress disorder: A systematic review with narrative synthesis and consideration of military and veteran populations

Psychiatry and Clinical Neurosciences Reports October 7, 2026 Mary Ivasyutyn, Saajan Bhakta

Abstract Post‐traumatic stress disorder (PTSD) is a debilitating disorder with limited pharmaceutical treatment options. Ketamine, a noncompetitive N ‐methyl‐ d ‐aspartate (NMDA) receptor antagonist with rapid‐onset effects, has emerged as a potential treatment, particularly for patients who do not respond to first‐line therapies. This systematic review synthesizes the current evidence on the...

DOI: 10.1002/pcn5.70425 (opens in new tab)

Multi-center, randomized controlled efficacy and comparative-effectiveness study evaluating ketamine, stellate ganglion blocks, combination treatment, and sham treatments for posttraumatic stress disorder and traumatic brain injury-associated headache: a study protocol

Pain Management October 1, 2026 Steven Paul Cohen, Roman Smolynets, Jordan Wood et al.

BACKGROUND: Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are conditions that share common mechanisms and are highly co-prevalent with each other and chronic pain. This pragmatic study will compare ketamine infusions to stellate ganglion blocks (SGB), their combination, and a placebo-sham-controlled arm. METHODS: A double-blind study conducted at 3 U.S. and Ukrainian...

DOI: 10.1080/17581869.2026.2738419 (opens in new tab)

Blood biomarker changes in response to low-dose oral ketamine treatment in adults with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD)

medRxiv August 14, 2026 Annette M Braxton, Christina Driver, Daniel F. Hermens et al. preprint

Abstract Major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) are prevalent, chronic, and disabling mental health conditions which are difficult to treat. Ketamine has demonstrated effect for improving depression and PTSD symptoms independently but reports often overlook focused comorbid improvement of these symptoms within individuals. To address this, we assessed...

DOI: 10.64898/2026.08.12.26360216 (opens in new tab) Full text (opens in new tab)

Efficacy of intraoperative ketamine in attenuating emergence agitation in patients with sexual trauma-related post-traumatic stress disorder

Australian and New Zealand Continence Journal August 11, 2026 Janine Stirling, M. Doane, M. Simon et al.

Post-traumatic stress disorder places patients at risk for emergence agitation following surgical procedures under general anaesthesia. Gynaecological procedures, sphincteroplasty, and surgical interventions involving the pelvic floor can involve vulnerable patient positioning in theatre, with inserted catheters and sensory stimulation. Such interventions could contribute to postoperative...

DOI: 10.1071/cj25013 (opens in new tab) Full text (opens in new tab)

Psychedelic Therapies in the Management of Post-Traumatic Stress Disorder

Journal of Education, Health and Sport July 16, 2026 Jakub Bajer, Aleksandra Włodarczyk, Hubert Kulawinek et al.

Background. Post-Traumatic Stress Disorder (PTSD) is an important public health challenge typically treated with trauma-focused psychotherapy and Selective Serotonin Reuptake Inhibitors (SSRIs). However, high rates of residual symptoms associated with these standard treatments have led to a renewed interest in psychedelic-assisted therapies. Aim. This review attempts to examine emerging...

DOI: 10.12775/jehs.2026.94.73071 (opens in new tab) Traumatic stress Ketamine Psilocybin Anxiety disorder +5

Ketamine effects on EEG and their links to therapy differ across treatment-resistant major depression, post-traumatic stress disorder, and obsessive-compulsive disorder

The International Journal of Neuropsychopharmacology July 6, 2026 Shabah M. Shadli, Neda Nasrollahi, Calvin K. Young et al.

BACKGROUND: Neurotic disorders - major depressive disorder (MDD), panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobia - have differing pharmaceutical profiles. But all, even when resistant to conventional treatment (TR), respond quickly to low dose (0.5-1.0 mg/kg I.M.) ketamine....

DOI: 10.1093/ijnp/pyag037 (opens in new tab) Full text (opens in new tab) Panic disorder Ketamine Anxiety disorder Major depressive disorder +11

Effect of esketamine-assisted regional block on post-traumatic stress disorder after radical lung cancer surgery: A retrospective clinical study

World Journal of Psychiatry June 19, 2026 Yan-Lin Chen, Tengchen Feng, Xiao-Min Zhang et al.

BACKGROUND Post-traumatic stress disorder (PTSD) is a common psychological complication after radical lung cancer surgery and has a significant impact on postoperative recovery and quality of life. Esketamine, a new anesthetic agent, may be protective against postoperative PTSD through modulation of neurotransmitter systems and anti-inflammatory actions. AIM To explore the underlying mechanisms...

DOI: 10.5498/wjp.v16.i6.119817 (opens in new tab) Full text (opens in new tab)

Ketamine-assisted psychotherapy for posttraumatic stress disorder: a systematic review and individual participant data meta-analysis of predictors of treatment effects.

Psychotherapy and Psychosomatics June 19, 2026 Judith Rohde, Tyler M Moore, Kathryn Walker et al.

Ketamine combined with psychotherapy has shown promise in treating posttraumatic stress disorder (PTSD), but predictors of clinical benefit remain unclear. In this systematic review and individual participant data meta-analysis (IPDMA), we examined patient- and treatment-level predictors of PTSD symptom change after combined treatment. Eligible studies combined ketamine with psychotherapy in...

DOI: 10.1159/000553144 (opens in new tab) Full text (opens in new tab)

Clinical trials

All ketamine for ptsd trials →