Repeated intravenous (IV) ketamine infusions significantly reduce symptom severity in individuals with chronic post-traumatic stress disorder (PTSD). The improvement is rapid and maintained for several weeks afterward, according to a study conducted by researchers from the Icahn School of Medicine at Mount Sinai. The study, published on January 5 in the American Journal of Psychiatry, is the first randomized, controlled trial of repeated ketamine administration for chronic PTSD therapy and suggests this may be a promising treatment for PTSD patients.

According to Adriana Feder, MD, Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and lead author of the study, the findings provide insight into the treatment efficacy of repeated ketamine administration for PTSD. This study is essential in developing novel pharmacologic interventions for this chronic and disabling disorder, as currently available treatments do not sufficiently help many individuals. The data suggest that repeated IV ketamine is a promising treatment option for people with PTSD and supports the need for future studies to determine how to maintain this rapid and robust response over time.

Before the current study, researchers from Mount Sinai conducted a randomized, controlled trial of a single intravenous dose of ketamine for PTSD as a proof-of-concept. The trial demonstrated a significant and rapid reduction of PTSD symptoms 24 hours after the infusion. Ketamine, approved by the U.S. Food and Drug Administration as an anesthetic agent in 1970, acts as an antagonist of the N-methyl-d-aspartate (NDMA) receptor, an ionotropic glutamate receptor in the brain. On the other hand, commonly used antidepressants target neurotransmitters such as serotonin, norepinephrine, and dopamine and can take several weeks or even months to take effect. These drugs are ineffective in at least one-third of cases and only partially effective in another third.

Dennis S. Charney, MD, Anne and Joel Ehrenkranz, Dean of the Icahn School of Medicine at Mount Sinai and President of Academic Affairs for the Mount Sinai Health System, and senior author of the paper stated that the data presented in the current study, not only replicates but also expands on the initial findings about the use of ketamine for PTSD. The study indicates that ketamine produces an immediate effect and can maintain its development for several weeks. As PTSD is a highly debilitating condition, the team is pleased that their discovery may lead to a treatment option for individuals who require relief from their suffering.

In the current study, individuals with severe and chronic PTSD from civilian or military trauma were randomly assigned to receive six infusions of ketamine administered three times per week over two consecutive weeks or six infusions of the psychoactive placebo control midazolam. Midazolam was chosen due to its pharmacokinetic parameters and nonspecific behavioral effects similar to ketamine. Approximately half of the sample took concomitant psychotropic medications, and the median duration of PTSD was 14 years. The primary traumas reported by participants included sexual assault or molestation, physical assault or abuse, witnessing violent assault or death, having survived or responded to the 9/11 attacks, and combat exposure. Study participants were assessed at baseline, week 1, and week 2, and on each infusion day by trained study raters who administered the Clinician-Administered PTSD Scale for DSM-5 and the Montgomery-Asberg Depression Rating Scale (MADRS), which are standard rating scales for assessing PTSD and depression.

The study on mental health services in Israel found that a significantly higher percentage of participants in the ketamine group (67 percent) achieved a reduction of at least 30 percent in symptoms from baseline at week two compared to those in the midazolam group (20 percent). Additionally, ketamine infusions were associated with substantial improvements across three PTSD symptom clusters, including intrusions, avoidance, and negative alterations in cognition and mood. Among the subsample of ketamine responders, improvement in PTSD symptoms was rapid, observed 24 hours after the first infusion, and sustained for a median of 27.5 days after the primary outcome assessment day. Moreover, the ketamine group experienced a significant reduction in comorbid depressive symptoms than the midazolam group, which is noteworthy given the high prevalence of depression among individuals with PTSD. The study also suggested that repeated ketamine infusions were generally well-tolerated and safe in individuals with chronic PTSD.

Dr. Feder suggested that future studies should explore the efficacy of additional doses of ketamine over time and investigate the combination of repeated ketamine infusions with trauma-focused psychotherapy. These investigations could help researchers identify ways to sustain the observed positive response in patients with PTSD over the long term. Dr. Feder emphasized that this study provided hope to individuals with PTSD and reassured them that researchers are dedicated to gathering information that will eventually lead to effective relief from their symptoms.

Ketamind Clinic Israel
Ketamind Clinic Israel has developed two distinct Ketamine IV Therapy treatment protocols, one for mental health, such as depression and PTSD, and another for chronic pain. The mental health protocol is tailored to alleviate the effects of depression, anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, bipolar disorder, and suicidal ideation on the brain. The chronic pain protocol aims to provide lasting relief to those suffering from neuropathic pain, fibromyalgia, and Complex Regional Pain Syndrome. Patients who undergo these protocols may witness significant reductions in their need for antidepressants, mood disorders, and opiate prescriptions.

Best Therapy for PTSD
Ketamine therapy for PTSD has emerged as a promising treatment option for individuals with PTSD. Unlike traditional antidepressants that take weeks to months to show effect, ketamine therapy can provide rapid and sustained relief from PTSD symptoms. Ketamine targets the N-methyl-D-aspartate (NMDA) receptor in the brain, which is involved in the formation and retrieval of traumatic memories. Studies have shown that ketamine therapy can significantly reduce symptom severity, including intrusive thoughts, avoidance behaviors, and negative mood. Additionally, ketamine is safe and well-tolerated, with few side effects. Overall, ketamine therapy offers a novel and practical approach to treating PTSD.

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