Trial PaperAnxiety DisordersDepressive DisordersPTSDVeteransSubstance Use Disorders (SUD)Ketamine

High-dose ketamine infusion for the treatment of posttraumatic stress disorder in combat veterans.

In an observational study of 30 combat veterans, six high‑dose 1‑hour ketamine infusions targeting a transpersonal dissociative experience produced large, statistically significant reductions in depressive (PHQ mean 18.9→9.5) and PTSD symptoms (PCL‑5 mean 56.2→31.3), while self‑reported substance use did not significantly change. These results suggest high‑dose ketamine infusion therapy may be a promising treatment for combat‑related PTSD and warrant controlled trials to confirm efficacy and clarify mechanisms.

Authors

  • Ross, C.
  • Jain, R.
  • Bonnett, C. J.

Published

American Academy of Clinical Psychiatrists
individual Study

Abstract

Introduction

Combat veterans are at high risk for the development of posttraumatic stress disorder (PTSD) and substance use disorders. Ketamine has been shown to be an effective treatment for numerous mental health disorders, although research on its efficacy in combat-related PTSD in veterans is very limited.

Methods

The study population consisted of 30 US military veterans with combat-related PTSD. Participants underwent a standard induction series of six 1-hour ketamine infusions with the goal of obtaining a transpersonal dissociative experience. Participants were given a series of self-report questionnaires to assess for changes in symptoms of depression, PTSD, and substance use prior to the first and sixth infusions.

Results

Symptoms of depression as measured by change in score on the Patient Health Questionnaire decreased significantly from an average of 18.9 to 9.5 ( P < .001). Similarly, symptoms of PTSD as measured by change in score on the PSTD Checklist for DSM-5 dropped significantly from an average of 56.2 to 31.3 ( P < .001). Self-reported levels of substance use did not significantly decrease during the study period, although the level of use trended down.

Conclusions

This observational study suggests that high-dose ketamine infusion therapy, which induced a transpersonal dissociative experience, could be a valuable tool in the treatment of combat-related PTSD. Further study is needed to better elucidate ketamine's mechanism of action with regards to the treatment of PTSD.

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Research Summary of 'High-dose ketamine infusion for the treatment of posttraumatic stress disorder in combat veterans.'

Introduction

Combat veterans face a high burden of posttraumatic stress disorder (PTSD) together with frequent comorbid mental health and substance use problems, and many do not receive adequate care. Earlier research has shown ketamine’s rapid antidepressant effects and emerging signals of benefit in PTSD, but there is limited evidence specifically addressing combat-related PTSD in veteran populations and little investigation of higher-dose, experiential ('psychedelic') ketamine regimens. Ross and colleagues designed the present study to characterise outcomes after a high-dose ketamine induction series in US military veterans with clinician-diagnosed combat-related PTSD. The primary aim was to describe changes in self-reported PTSD and depressive symptoms following an induction of six 1-hour ketamine infusions targeted to produce a transpersonal dissociative experience, and to report safety and substance-use-related measures in this cohort.

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Study Details

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References (7)

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