Ketamine’s surprisingly fast treatment for PTSD and depression

Ketamine’s surprisingly fast treatment for PTSD and depression

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Ketamine depression help concept art

The drug ketamine has shown promising results in quickly reducing symptoms of post-traumatic stress disorder and depression, according to a recent study published in the journal Annals of pharmacotherapy. While it is traditionally used as an anesthetic and is sometimes abused, ketamine’s potential in mental health treatment is being explored.

Recent research suggests that ketamine, a traditional anesthetic, can rapidly decrease depression Post-traumatic stress disorder And symptoms of depression. This finding is important given the slow onset of conventional PTSD treatments. However, questions remain about the optimal frequency and dosage of ketamine treatments, and the risks associated with its abuse are notable.

Ketamine can reduce post-traumatic stress disorder, or PTSD, symptoms of depression in patients as early as one day after the injection. This is the main finding of a new meta-analysis conducted by my team, which has just been published in the journal Annals of pharmacotherapy.

Ketamine is an anesthetic that is sometimes used as an anesthetic but is increasingly being explored as a treatment for a range of mental health conditions.

Study analysis and results

In our study, we analyzed six randomized controlled trials representing 259 patients with moderate to severe PTSD. In all experiments, about half were injected with ketamine. The rest received either saline or midazolam, a benzodiazepine like Xanax that is also used as an anesthetic agent.

Patients receiving ketamine saw a reduction in PTSD symptoms of approximately 25% at one day and one week after treatment. However, if patients received repeated injections over four weeks, PTSD symptoms decreased by only 12%. The reduction in depressive symptoms was more modest but still significant.

In most of these trials, patients received only one dose; In the other two, they were given an injection with the same dose six or more times over two to four weeks. Benefits after the first injection were similar across studies, but it is unclear how well additional doses of ketamine over time maintain these benefits.

Overall, the benefits of even a single injection of ketamine occur quickly, but are modest in magnitude. The best regimen for maintaining these benefits via ketamine reinjection has not been determined.

The importance of ketamine for PTSD

PTSD, a debilitating mental health disorder, occurs when past trauma causes flashbacks, nightmares, depressed mood, anxiety, and avoidance of activities that can trigger traumatic memories. Patients with PTSD are twice as likely to attempt suicide than the general population.

About 13 million Americans suffer from PTSD in a given year, which translates to approximately 5% of the adult population. PTSD is caused by experiencing or witnessing a traumatic event. Many veterans suffer from this disorder, as do survivors of physical abuse, natural disasters, child abuse, and sexual assault. People with moderate to severe illness miss an average of about three and a half days of work per month due to triggering symptoms or treatment of the illness.

Current treatments and advantages of ketamine

Trauma-focused psychotherapy — techniques that help patients remember, process and respond to traumatic memories — is the treatment of choice for PTSD, but it may take several weeks to see benefits, and not all patients respond.

For these people, antidepressants such as paroxetine, sertraline, and venlafaxine are recommended as alternatives or as an addition to psychotherapy.

But like psychotherapy, these medications may not work for a while — about five to eight weeks — unlike ketamine, which seems to start working almost immediately. However, the reduction in PTSD and depression symptoms over time after ketamine injections is about the same as that provided by traditional antidepressants once they take effect.

Because some people with severe PTSD may experience suicidal thoughts, time is of the essence; They simply may not be able to wait for traditional options to start working. Ketamine may serve as an effective bridge to immediately reduce patients’ symptoms until trauma-focused psychotherapy and other antidepressants are initiated.

Unresolved questions and costs

The big unknown about using ketamine to treat PTSD and depressive symptoms is how often injections will be needed. The data simply is not strong enough to determine whether multiple doses maintain effects better than just using a single dose.

Ketamine costs about $800 per injection, so knowing how much to give each treatment and how many injections to give over time is important.

Risks of ketamine abuse

Most importantly, ketamine can be abused. If purchased from unlicensed pharmacies or online stores, the ketamine product is not approved by the Food and Drug Administration. It may not have the correct dose, it may have expired, or it may not have any ketamine in it. Or it may contain an alternative drug that contains a dangerous active ingredient, such as the synthetic drug LSD found on the streets. Such counterfeit products can harm or even kill patients.

Written by C. Michael White, Professor of Pharmacy Practice, University of Connecticut.

Adapted from an article originally published on The Conversation.Conversation

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