Ketamine For Post-Traumatic Stress Disorders And Its Possible Therapeutic Mechanism

Introduction

Post-traumatic stress disorder (PTSD) is described as a debilitating psychiatric condition that can follow exposure to life‑threatening events. Epidemiological estimates reported in the paper place lifetime PTSD at about 8% in the general population, with markedly higher rates following severe trauma (up to 23% in combat veterans, 50% in rape victims and 80% in Holocaust survivors). Current first‑line pharmacotherapies are selective serotonin reuptake inhibitors (SSRIs), but these have a slow onset, limited remission rates (cited as around 30%) and tolerability problems that limit adherence, leaving many patients without adequate benefit from existing drug or psychological treatments. Asim and colleagues set out to review preclinical and clinical evidence on ketamine as a potential treatment for PTSD and to synthesise hypotheses about its molecular and circuit mechanisms. The review aims to bring together animal and human findings on efficacy, dose‑ and timing‑dependent effects, implicated glutamatergic and neurotrophic signalling pathways (including NMDA, AMPA, BDNF and mTOR), and other candidate mediators such as metabotropic glutamate receptors and cholecystokinin, with a view to identifying gaps and directions for future research.