Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event.  This event may involve actual or threatened death, serious injury, or sexual violence. About 5 out of every 100 adults or 5% of  the U.S. population has PTSD in any given year. It’s important to remember that PTSD is a normal reaction to abnormal events and not a sign of weakness.

Signs and Symptoms of PTSD

The symptoms of PTSD can vary widely from person to person, but they generally fall into four categories:

• Intrusive thoughts: Recurring, unwanted distressing memories of the traumatic event, flashbacks, nightmares, or emotional distress triggered by reminders of the trauma.
• Avoidance: Avoiding thoughts, feelings, or external reminders (people, places, conversations) associated with the traumatic event.
• Negative thoughts and feelings: Persistent negative beliefs about oneself or the world, feelings of detachment, emotional numbness, difficulty experiencing positive emotions, or memory problems regarding the traumatic event.
• Arousal and reactivity: Being easily startled, feeling on edge, difficulty concentrating, irritability or anger outbursts, reckless or self-destructive behavior, or sleep disturbances.

These symptoms can significantly interfere with daily life, relationships, and overall well-being.

Treatment Options for PTSD

While the effects of PTSD can be long-lasting, there are several treatments that can help manage symptoms and promote recovery:

• Psychotherapy: Trauma-focused therapy, such as Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) therapy, can help individuals process the traumatic experience, challenge negative thoughts, and develop coping skills.
• Medications: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can help manage symptoms like sadness, worry, anger, and sleep problems associated with PTSD.
• Support Groups: Connecting with others who have shared similar experiences can provide invaluable support and understanding, reducing feelings of isolation and fostering hope.

Sadly, for some people, traditional treatments may not provide complete relief, leaving them struggling with lingering symptoms that hinder their well-being.

Ketamine as a Potential Treatment for PTSD

Ketamine has emerged as a potential treatment option for PTSD, particularly for individuals who haven’t responded adequately to traditional therapies. Its rapid-acting antidepressant effects can offer significant relief from PTSD symptoms, including intrusive thoughts, flashbacks, and emotional numbness. Research suggests that Ketamine may work for PTSD by:

• Enhancing neuroplasticity: By promoting the growth and connections of brain cells, ketamine may help “rewire” the brain and facilitate the processing of traumatic memories.
• Modulating the glutamate system: Ketamine’s impact on glutamate, a crucial neurotransmitter, may play a role in reducing the emotional intensity of traumatic memories and improving mood.
• Reducing inflammation: Ketamine’s anti-inflammatory properties may help mitigate the negative effects of chronic stress and trauma on the brain.

While promising, ketamine treatment for PTSD is still under investigation, and its long-term effects and optimal treatment protocols are being explored. It’s crucial to approach ketamine treatment with caution and under the guidance of a qualified healthcare professional.

Finding Hope and Healing

Living with PTSD can be challenging, but it’s essential to remember that recovery is possible. With the right treatment and support, individuals with PTSD can find relief from their symptoms and rebuild their lives. Seeking professional help, exploring evidence-based therapies, and considering emerging treatments like ketamine can offer hope and pave the path towards healing and a brighter future. Contact our office today to determine if Ketamine therapy is right for you. 

Ketamine and PTSD

Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder: A Randomized Clinical Trial | Psychiatry and Behavioral Health

• Feder, Parides et al.  “Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial.”  JAMA Psychiatry. 2014 Jun;71(6):681-8.

SUMMARY:  In this double blind, placebo-controlled crossover study, a single dose of Ketamine (.5mg/kg over 40 minutes) was compared to midazolam.  Authors note a significant immediate reduction in the CAPS score and frequently this reduction was maintained for over 2 weeks.  The only side effects noted were transient dissociative symptoms, none of which required stopping the infusion.

 

A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder | American Journal of Psychiatry

• Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., … & Charney, D. S. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193-202.

SUMMARY: This randomized controlled trial thirty individuals with chronic PTSD were randomly assigned to receive six infusions of either ketamine (0.5 mg/kg) or midazolam (0.045 mg/kg) over two weeks. Results showed that the ketamine group experienced a significantly greater improvement in CAPS-5 scores compared to the midazolam group. Furthermore, 67% of participants in the ketamine group were considered treatment responders (experiencing a 30% or greater reduction in symptoms), compared to only 20% in the midazolam group. Responders to ketamine maintained improvement for a median duration of 27.5 days following the treatment course. Importantly, ketamine infusions were well tolerated, with no serious adverse events reported. 

 

The Multivariate Effect of Ketamine on PTSD: Systematic Review and Meta-Analysis

• Du, R., Han, R., Niu, K., Xu, J., Zhao, Z., Lu, G., & Shang, Y. (2022). The multivariate effect of ketamine on PTSD: Systematic review and meta-analysis. Frontiers in psychiatry, 13, 813103.

SUMMARY: The systematic review and meta-analysis examined the effect of ketamine on PTSD, analyzing data from 10 studies with a total of 705 participants. The study found that while ketamine did not affect the development of PTSD in injured soldiers, it did have varying effects on PTSD symptoms depending on the duration of the condition. Ketamine treatment significantly improved symptoms in patients with chronic PTSD (lasting more than 3 months), however this same benefit was not observed in patients with early PTSD (within 1-3 months of the traumatic event).