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Abstract

Posttraumatic stress disorder (PTSD) is a chronic and debilitating condition. Although several psychotherapeutic and pharmacological treatments are recommended for PTSD, many individuals do not respond to treatment or respond only partially, highlighting a critical need for additional treatments. Ketamine has the potential to address this therapeutic need. This review discusses how ketamine emerged as a rapid-acting antidepressant and has become a potential treatment for PTSD. A single dose of intravenous (IV) ketamine has been shown to facilitate rapid reduction of PTSD symptoms. Repeated IV ketamine administration significantly improved PTSD symptoms, compared with midazolam, in a predominantly civilian sample of individuals with PTSD. However, in a veteran and military population, repeated IV ketamine did not significantly reduce PTSD symptoms. Further study of ketamine as a treatment for PTSD is necessary, including which populations benefit most from this therapy and the potential benefits of combining psychotherapy and ketamine.

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History

Published in print: Summer 2023
Published online: 14 July 2023

Keywords

  1. Posttraumatic Stress Disorder
  2. Trauma-and Stressor-Related Disorders

Authors

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Rachel Fremont, M.D., Ph.D.
Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York.
Oneysha Brown, B.A.
Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York.
Adriana Feder, M.D.
Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York.
James Murrough, M.D., Ph.D. [email protected]
Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry (all authors), and Nash Family Department of Neuroscience (Murrough), Icahn School of Medicine at Mount Sinai, New York.

Notes

Send correspondence to Dr. Murrough ([email protected]).

Competing Interests

The Icahn School of Medicine (authors’ employer) is named on a patent, has entered into a licensing agreement, and will receive payments related to the use of ketamine or esketamine for the treatment of depression; the Icahn School of Medicine is also named on a patent related to the use of ketamine for the treatment of posttraumatic stress disorder (PTSD). Dr. Feder is named as a coinventor on a U.S. patent, and on several non-U.S. patents filed by the Icahn School of Medicine at Mount Sinai, for the use of ketamine as therapy for PTSD; this intellectual property has not been licensed. Dr. Murrough has provided consultation services or served on advisory boards for Biohaven, Boehringer Ingelheim, Clexio Biosciences, Compass Pathfinder, Engrail Therapeutics, FSV7, Otsuka, and Sage Therapeutics.

Competing Interests

The other authors report no financial relationships with commercial interests.

Funding Information

This work was supported in part by Gerald and Glenda Greenwald and by the Ehrenkranz Laboratory for Human Resilience, a component of the Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine at Mount Sinai.

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