Self-reported improvements in comorbid post-traumatic stress disorder symptoms, depression, anxiety, and sleep among real-world patients receiving medical ketamine: Exploring the role of adjunct therapies

Mar 9, 2026European journal of trauma & dissociation = Revue europeenne du trauma et de la dissociation

Self-Reported Improvements in PTSD, Depression, Anxiety, and Sleep in Patients Using Medical Ketamine and the Impact of Additional Therapies

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Abstract

Participants with comorbid PTSD reported improvements in multiple symptoms after ketamine treatment.

Patients with PTSD reported more severe depression, anxiety, and sleep disturbances before starting ketamine compared to those without PTSD.
There were no significant differences in current depression, anxiety, and sleep scores between patients with PTSD and those without after ketamine treatment.
Most patients with PTSD indicated they received additional therapy, primarily psychotherapy, yet similar improvements were noted in those who did not receive any adjunct therapy.
Ketamine treatment was associated with the reprocessing of trauma as observed through patients' subjective experiences.
Further research is needed to explore the role of additional psychological and somatic therapies in optimizing PTSD treatment.

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INTRODUCTION: Post-traumatic stress disorder (PTSD) presents severe symptomology and often co-occurs with depression, warranting novel treatment approaches to address both conditions simultaneously. Ketamine has emerged as a rapid antidepressant and potential treatment for PTSD, with some real-world evidence for effectiveness regardless of comorbidities. The purpose of this secondary analysis was to explore the perceived and self-reported outcomes of ketamine treatment in real-world patients with comorbid PTSD.

METHODS: In an anonymous online survey with quantitative and qualitative items, real-world patients (=202) completed measures of depression, anxiety, and sleep disturbance twice, reflecting retrospective pre-ketamine initiation and current symptoms. Patients with comorbid PTSD elaborated on their experiences of changes in symptoms of PTSD. We described subjective experiences regarding PTSD outcomes and potential underlying processes of ketamine's therapeutic effects. We compared patients diagnosed with PTSD versus those without, on pre-ketamine and current depression, anxiety, and sleep. N

RESULTS: Participants with comorbid PTSD (=98) described improvements in multiple PTSD symptoms. They reported more severe/frequent depression, anxiety, and sleep disturbance prior to ketamine compared to patients without PTSD (s<.017) but responded to ketamine just as well, with no differences in current scores (s>.259). Most PTSD patients reported receiving adjunct therapy, mostly psychotherapy, however, similar improvements were also reported by those receiving none. n p p

DISCUSSION: As perceived by real-world patients, ketamine successfully improved an array of symptoms and allowed reprocessing of the trauma. Targeted longitudinal and qualitative research is needed in larger, more diverse samples on the role and effects of other adjunct psychological and somatic therapies to inform and optimize PTSD treatment protocols.