Ketamine for treatment-resistant post-traumatic stress disorder: double-blind active-controlled randomised crossover...

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Research

Background:

• Post-traumatic stress disorder (PTSD) presents a significant challenge, with limited effective treatments.
• Ketamine is emerging as a potential therapeutic agent for PTSD, necessitating further investigation.

Purpose of the Study:

• To evaluate the short-term efficacy and tolerability of intramuscular (i.m.) ketamine versus i.m. fentanyl in patients with treatment-resistant PTSD.
• To compare different doses of i.m. ketamine (0.5 mg/kg and 1.0 mg/kg) against a psychoactive control.

Main Methods:

• A randomized, double-blind, psychoactive-controlled study involving single i.m. doses of ketamine or fentanyl.
• Participants (18-50 years) had treatment-refractory PTSD.
• Primary outcome: Impact of Events Scale - Revised (IESR); Secondary outcome: Clinician-Administered Dissociative States Scale.

Main Results:

• Ketamine, especially at 1.0 mg/kg, significantly reduced IESR scores, with effects persisting for one week.
• Thirty-three participants completed the study; ketamine was associated with transient dissociative and cardiovascular effects.
• No significant difference was found in tolerability between ketamine and fentanyl groups.

Conclusions:

• Preliminary evidence supports the efficacy and tolerability of i.m. ketamine for PTSD in a community setting.
• Further research is needed to optimize ketamine dosing and determine its long-term role in PTSD treatment.
• Findings are encouraging for developing novel PTSD therapies.