A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder

Summary & key facts

This small randomized trial tested six IV ketamine infusions (0.5 mg/kg) given over 2 weeks versus midazolam (0.045 mg/kg) in 30 people with chronic PTSD. The ketamine group had larger drops in PTSD symptoms at 2 weeks, more people met the study’s response criteria, and ketamine was generally well tolerated. The authors describe these as the first randomized-trial results showing benefit of repeated ketamine for chronic PTSD, but they say more study is needed to confirm and better understand the treatment.

Key facts:

• The trial enrolled 30 people with chronic PTSD who were randomly assigned 1:1 to ketamine or midazolam.
• Participants received six intravenous infusions over 2 consecutive weeks: ketamine 0.5 mg/kg or midazolam 0.045 mg/kg (a psychoactive placebo control).
• The main outcome was change in PTSD symptoms measured by the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) from baseline to 2 weeks.
• At week 2, the mean CAPS-5 total score was 11.88 points lower in the ketamine group than in the midazolam group (SE = 3.96). The reported effect size was d = 1.13 (95% CI = 0.36 to 1.91).
• Sixty-seven percent of participants in the ketamine group were treatment responders, compared with 20% in the midazolam group.
• Among those who responded to ketamine, the median time to loss of response was 27.5 days after completing the 2-week infusion course.
• Ketamine infusions were reported to be generally well tolerated in this trial, and no serious adverse events were reported.
• The authors state these results provide initial randomized controlled evidence of efficacy for repeated ketamine in chronic PTSD and note that further studies are needed to understand its full potential.

Abstract

This randomized controlled trial provides the first evidence of efficacy of repeated ketamine infusions in reducing symptom severity in individuals with chronic PTSD. Further studies are warranted to understand ketamine's full potential as a treatment for chronic PTSD.

Topics

Anesthesia and Neurotoxicity Research Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Administration (probate law) Anesthesia Chronic stress Clinical psychology Internal medicine Ketamine Law Medicine Political science Posttraumatic stress Psychology Randomized controlled trial