Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis.

Apr 1, 2024Clinical neuropsychiatry

Ketamine's effectiveness for treating post-traumatic stress disorder: A systematic review and combined analysis

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Abstract

Ketamine treatment resulted in significant improvements in PTSD symptoms, with a standardized effect size of 0.25 at the treatment endpoint.

Improvements in PTSD symptom severity were measured using the PCL-5 scale.
Significant effects were observed 24 hours post-infusion and at the end of treatment.
The treatment duration across studies varied from 1 to 4 weeks.
Statistical analysis indicated a p-value of 0.0363 for the effect at the endpoint.
High variability among studies was noted, suggesting heterogeneity in responses.

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OBJECTIVE: Post-traumatic stress disorder (PTSD) is an enduring condition characterized by a chronic course and impairments across several areas. Despite its significance, treatment options remain limited, and remission rates are often low. Ketamine has demonstrated antidepressant properties and appears to be a promising agent in the management of PTSD.

METHOD: A systematic review was conducted in PubMed/MEDLINE, Cochrane Library, Clinicaltrials.gov, Lilacs, Scopus, and Embase, covering studies published between 2012 and December 2022 to assess the effectiveness of ketamine in the treatment of PTSD. Ten studies, consisting of five RCTs, two crossover trials, and three non-randomized trials, were included in the meta-analysis.

RESULTS: Ketamine demonstrated significant improvements in PCL-5 scores, both 24 hours after the initial infusion and at the endpoint of the treatment course, which varied between 1 to 4 weeks in each study. Notably, the significance of these differences was assessed using the Two Sample T-test with pooled variance and the Two Sample Welch's T-test, revealing a statistically significant effect for ketamine solely at the endpoint of the treatment course (standardized effect size= 0.25; test power 0.9916; 95% CI = 0.57 to 17.02, p=0.0363). It is important to note that high heterogeneity was observed across all analyses.

CONCLUSIONS: Our findings suggest that ketamine holds promise as an effective treatment option for PTSD. However, further trials are imperative to establish robust data for this intervention.

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Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis.

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