Hope for People with PTSD:  Six Ketamine Infusions

The American Journal of Psychiatry (January 5, 2021) presented the results of a study that showed ketamine infusions rapidly reduced the symptoms of post traumatic stress disorder (PTSD).  This research was conducted at the Icahn School of Medicine at Mount Sinai in New York.  Repeated IV ketamine infusions were well tolerated and safe.

Individuals participating in this study were diagnosed with chronic PTSD with symptoms lasting an average of 14 years.  There are three symptom clusters associated with PTSD (Scher et al., 2008).

Intrusive Cluster:  This cluster of symptoms includes nightmares and flashbacks.   These are disturbing, involuntary thoughts or images that may become obsessive and distressing.  People often feel as though they cannot control these thoughts and images (Scher, et al., 2008).

Avoidance Cluster: This cluster of symptoms includes emotional numbing, dissociation, and avoiding situations that bring up memories.  These are actions are an attempt to alleviate the distress of symptoms and includes dissociation and substance use/abuse.  These while helpful temporarily end up causing more harm (Scher, et al., 2008).

Hyperarousal Cluster: This cluster of symptoms includes insomnia, poor attention, hypervigilance, and paranoia.  This is a disturbing inability to relax, experience peace, and leads to overaction of the sympathetic nervous system (i.e., rapid heart rate, rapid breathing, “fight or flight”) (Scher, et al., 2008).

The study separated participants into 2 groups:  one group received 6 low dose ketamine infusions (3x per week for 2 weeks) and the other group received midazolam (an antianxiety medication) at the same frequency.

Results showed that the ketamine group experienced a decrease in symptoms leading to less distress, in fact, 67% of participants in this group had a 30% reduction of symptoms.  Interestingly, the ketamine group also had a reduction in co-existing depressive symptoms.

Symptom reduction was experienced as quickly as 24 hours following the infusions and this improvement continued to be experienced for up to 4 weeks after the infusion.

“The data presented in our current study not only replicate, but also builds on our initial findings about ketamine for PTSD, indicating that in addition to being rapid, ketamine’s effect can be maintained over several weeks,” Dennis S. Charney, MD, and colleagues said (Feder, et al., 2021).

References

Feder, A, Costi, S, Rutter, S, Collins, Abigail B, Govindarajulu, Usha, Jha,  Manish K, Horn, Sarah R, Kautz, Marin, Corniquel, Morgan, Collins, Katherine A, Bevilacqua, Laura, Glasgow, Andrew M, Brallier, Jess, Pietrzak, Robert H, Murrough, James W, Charney, Dennis S.  A randomized controlled trial of repeated Ketamine administration for chronic posttraumatic stress disorder.  The American Journal of Psychiatry:  2021 January 5. 

Scher, Christine D, McCreary, Donald R., Asmundson, Gordon J.G, Resick, Patricia A. “The Structure of Post-Traumatic Stress Disorder Symptoms in Three Female Trauma Samples: a Comparison of Interview and Self-Report Measures.” Journal of Anxiety Disorders, U.S. National Library of Medicine, Oct. 2008