Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression

May 5, 2018The Journal of clinical psychiatry

Effectiveness and Safety of Repeated Ketamine Treatments for People with Both PTSD and Hard-to-Treat Depression

AI simplified

Psychedelic Science on OpenScience ↗PubMed ↗DOI ↗

Abstract

A 80.0% remission rate for PTSD was observed in veterans receiving repeated ketamine infusions.

Significant symptom reductions were noted for both PTSD and treatment-resistant depression, with large effect sizes.
The mean decrease in PTSD Checklist for DSM-5 scores was 33.3 points, while the mean decrease in depression ratings was 26.6 points.
The response rate for treatment-resistant depression was 93.3%.
Participants in remission from PTSD had a median time to relapse of 41 days, and those responding for depression had a median time to relapse of 20 days.
Transient increases in dissociative symptoms were associated with the ketamine infusions, but no worsening of PTSD symptoms was reported.

AI simplified

OBJECTIVE: The present study examined the efficacy, safety, and durability of repeated ketamine infusions for the treatment of comorbid posttraumatic stress disorder (PTSD) and treatment-resistant depression (TRD) in a sample of veterans.

METHODS: Individuals with comorbid DSM-5-defined PTSD and DSM-IV-defined major depressive disorder (N = 15) received 6 intravenous ketamine infusions (0.5 mg/kg) on a Monday-Wednesday-Friday schedule over a 12-day period from May 2015 to June 2016. Data from outcome measures were collected before and 24 hours after each infusion and weekly for 8 weeks following the final infusion.

RESULTS: Continuous measures of symptom change were significant for both disorders and were associated with large effect sizes (mean decrease in PTSD Checklist for DSM-5 score = 33.3 points [95% CI, 23.0-43.5 points], P < .0005, sample size-adjusted Cohen d [d'] = 2.17; mean decrease in Montgomery-Asberg Depression Rating Scale score = 26.6 points [95% CI, 23.0-30.2 points], P < .0005, d' = 4.64). The remission rate for PTSD was 80.0%, and the response rate for TRD was 93.3%. Participants in remission from PTSD after the infusion series (n = 12) had a median time to relapse of 41 days. Similarly, participants whose depression symptoms responded to the infusion series (n = 14) had a median time to relapse of 20 days. Repeated ketamine infusions were associated with transient increases in dissociative symptoms. No participant reported worsening of PTSD symptoms over the study duration.

CONCLUSIONS: This study, the first open-label study of repeated ketamine infusions in a comorbid population, found rapid and sustained improvement in PTSD and depression symptoms. This report suggests that repeated ketamine treatments are safe and may represent an efficacious treatment for individuals with comorbid PTSD and TRD.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02577250.

Efficacy, Safety, and Durability of Repeated Ketamine Infusions for Comorbid Posttraumatic Stress Disorder and Treatment-Resistant Depression

Abstract

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the psychedelic science brief

Abstract

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the psychedelic science brief