The Effect of Transcranial Magnetic Stimulation and Oral Ketamine Combination Treatment on severity of symptoms in Post-Traumatic Stress Disorder (TMS-OK PTSD)

Randomised, parallel-group, double-blinded Phase II trial comparing active iTBS plus weekly oral ketamine (1 mg/kg, 6 doses) with sham iTBS plus the same ketamine regimen over a 6-week treatment period and 2 follow-ups.

TMS is delivered five days per week (30 sessions total); ketamine is administered on-site once weekly with 2-hour observation. Primary outcome includes PTSD symptom change (PCL-5) between baseline and follow-ups.