Ketamine Shows Promise for Those Coping with PTSD
If you’re one of the 12 million Americans living with post-traumatic stress disorder (PTSD), your symptoms can be a burden, and sometimes it may feel like your condition has brought life to a stop. However, there is hope. New research into a previously established drug, ketamine, has shown promising results for the treatment of PTSD. While researchers work toward understanding the exact mechanisms at play, early results reflect real potential for those suffering from PTSD.(1)
What You Need to Know About Ketamine
First developed in 1960 for veterinary medicine, ketamine received FDA approval for human use in the late 1970s.
Ketamine is a medication that has a long history of use as an anesthetic. First developed in 1960 for veterinary medicine, ketamine received FDA approval for human use in the late 1970s. Since then, it has gained popularity as the anesthetic of choice for pediatric and elder care. It is also a preferred option for surgical applications where patients are at an increased risk of respiratory complications due to its lack of negative impact on the respiratory system.
In the early 2000s, ketamine began gaining traction as a treatment for certain mental health conditions. Initially, this was limited to depression, but as research has grown, ketamine therapy has expanded to include anxiety, obsessive-compulsive disorder (OCD), PTSD, bipolar depression, substance abuse, and pain.
Ketamine is a medication that has a long history of use as an anesthetic. First developed in 1960 for veterinary medicine, ketamine received FDA approval for human use in the late 1970s. Since then, it has gained popularity as the anesthetic of choice for pediatric and elder care. It is also a preferred option for surgical applications where patients are at an increased risk of respiratory complications due to its lack of negative impact on the respiratory system.
In the early 2000s, ketamine began gaining traction as a treatment for certain mental health conditions. Initially, this was limited to depression, but as research has grown, ketamine therapy has expanded to include anxiety, obsessive-compulsive disorder (OCD), PTSD, bipolar depression, substance abuse, and pain.
What is PTSD?Post-traumatic stress disorder is a complex condition that can affect anyone who has been exposed to a traumatic event. PTSD is typically associated with an overactive flight or fight response. Many PTSD patients report dealing with hypervigilance (frequently feeling on guard or wary), reduced ability to regulate emotions, and in rare cases, anger.(2)
What are Some PTSD Symptoms?Post-traumatic stress disorder is associated with symptoms such as anxiety, fear of crowds, fear triggered by certain events, irritability, changes in mood, and even substance abuse. Many patients who have PTSD may also develop depression or other anxiety disorders. PTSD symptoms usually manifest within four weeks of a traumatic event but may not emerge for years.(3)
What Causes PTSD?PTSD can develop after any traumatic event. This could be trauma from losing a family member, sexual assault, a bad injury, exposure to something horrific, or battlefield trauma. PTSD impacts both men and women as well as children. Children can develop PTSD from abuse or bullying, along with any of the triggers listed above.(6)
How does Ketamine Therapy for PTSD Work? Post-traumatic stress disorder is a complicated and debilitating condition affecting millions of Americans. Although there exists a higher prevalence in the veteran community, anyone who goes through trauma can experience PTSD. Typically, PTSD symptoms are treated with a combination of selective serotonin reuptake inhibitors (SSRIs) and antipsychotic medication paired with psychotherapy. While these treatment methods can benefit some patients, approximately 40% of patients with PTSD will not respond to SSRIs, and only 20%−30% achieve complete remission following pharmacotherapy (therapy involving medication).(7)
Spurred by PTSD’s chronic and difficult-to-treat nature, researchers have begun exploring alternative modalities such as ketamine therapy. Recent clinical studies have shown that low-dose intravenous (IV) ketamine infusions paired with psychotherapy, a practice known as ketamine-assisted psychotherapy (KAP), can significantly reduce PTSD symptoms.(7)
A double-blind placebo-controlled study (a study where neither the researchers of participants know which group received the placebo) utilizing 30 randomly-assigned participants showed that ketamine-assisted psychotherapy could reduce PTSD symptoms by 30% or more. This 30% reduction in symptom severity is how medical professionals and clinicians define a significant improvement in a participant’s condition. Researchers saw the most significant improvement in the ketamine group vs. the midazolam (control) group.
Fifteen study participants received six single-dose IV ketamine infusions over six weeks. At the same time, fifteen patients were given a placebo control in the form of midazolam (a common anti-anxiety and sedative medication). Those that received ketamine treatments saw the greatest reduction in symptom severity, with 2/3rds responding well vs. only 1/5th of the control group.(7)
How Does Ketamine Treat PTSD?Ketamine works for PTSD by impacting the brain’s glutamate system, specifically the N-methyl-D-aspartate (NMDA) receptor. As an NMDA antagonist, ketamine changes how the NMDA receptor interacts with chemical messengers like glutamate, altering how it works in the brain. By altering the glutamate and NMDA receptor interaction, ketamine boosts the amount of available glutamate in the brain, which researchers believe is partly responsible for ketamine’s beneficial aspects.(8) For example, its purported ability to reduce anxiety, improve depressive symptoms, and even reduce feelings of suicidality. However, the exact mechanism is not entirely understood. There are many theories about how and why ketamine can treat certain mental disorders.(9)
Ketamine is also a powerful dissociative medicine, meaning it causes patients to feel temporarily detached or removed from themselves. Many ketamine therapy patients report that this gives them a top-down (more objective) view of themselves and their conditions. Ketamine’s dissociative qualities can also reduce the fear response that often accompanies reliving traumatic memories and events. By reducing the fear response, patients may be able to participate in psychotherapy more fully.(10)
Does Ketamine Carry Risks for PTSD Patients?Like most medications, ketamine carries some risks. Ketamine may cause PTSD patients to experience brief periods of confusion during administration. Some other ketamine treatment short-term side effects include drowsiness, lowered inhibition, stomach discomfort, and fatigue. Medical professionals recommend that people with schizophrenia consult their primary care provider before starting any ketamine treatment. Ketamine may also carry increased risks for people with high blood pressure.
Other short-term side effects of ketamine for PTSD patients include:(11)
Could Ketamine Help Manage Your PTSD?Post-traumatic stress disorder is a highly complex condition that requires expert care. Ketamine for PTSD may be a good option if you have exhausted other treatment modalities. Like all alternative care plans, ketamine may not be right for everyone, and not all patients will experience the same results with ketamine treatment.
However, ketamine could be a good option if you have failed to respond to other treatment modalities. Some studies have shown that ketamine therapy can provide rapid relief from PTSD symptoms, sometimes in as little as one session.
Consult a physician if you think ketamine for PTSD could be right for you. Studies have shown that ketamine for PTSD is relatively safe for some individuals and may be highly effective for certain mental health conditions. Generally speaking, psychiatric therapies, like ketamine therapy, require a professional medical diagnosis and sometimes a referral. Find a ketamine clinic near you to get started on your road to better mental health.
Sources Cited
- https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:text=The%20following%20statistics%20are%20based,PTSD%20during%20a%20given%20year.
- https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
- https://psychiatry.org/patients-families/ptsd/what-is-ptsd
- https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/
- https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/
- https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/causes/#:~:text=Post%2Dtraumatic%20stress%20disorder%20(PTSD)%20can%20develop%20after%20a,physical%20or%20sexual%20assault
- https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2020.20050596
- https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2020.20121677
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9053551/
- https://www.nature.com/articles/s41467-020-20190-4
- https://www.mayoclinic.org/drugs-supplements/ketamine-injection-route/side-effects/drg-20075559?p=1