Ketamine as treatment for post-traumatic stress disorder: a review

This review (2019) examines the lack of efficient treatment options for patients suffering from PTSD and explores the viability of ketamine for patients who do not respond to conventional treatment. It is thought that ketamine might reverse some of the damage caused by chronic stress, by means of upregulating BDNF and antagonizing NMDA. The review also notes that the deterrent of dissociative side-effects may be less common than previously reported and point to early evidence which supports that ketamine may yield a near-complete resolution of traumatic symptoms, albeit only over a short-term of 1-2 weeks.

Abstract

“Post-traumatic stress disorder (PTSD) continues to make headlines given multiple military engagements across the world and civilian traumas, and resultant PTSD development continues at an even pace. Currently, antidepressant and cognitive-behavioral therapy have the greatest evidence base but still do not yield a remission of PTSD symptoms in many patients. Off-label and novel treatments continue to be considered for more refractory and disabling cases of PTSD. Ketamine is one such treatment that has been discussed and utilized more often for treatment-resistant major depressive disorder (MDD). Its mechanism is controversial regarding its potential to create anxiety, but the perceived benefit of a rapid reduction of symptoms makes it worthy for study in animal models of, and possibly human studies in, PTSD. The current literature and theoretical mechanism of action is discussed in this manuscript.”

Authors: Felix Liriano, Candace Hatten & Thomas L. Schwartz