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Ketamine for PTSD

A rapid-acting medication for PTSD



Is Ketamine Treatment for PTSD Right for You?

  • Did you undergo a traumatic event or series of events that caused PTSD and you don’t know where to turn?
  • Have you tried psychotherapy for PTSD and no matter how many sessions you do it’s just not going away?
  • Does your PTSD impact your family, friends and career?

Psychological trauma is a serious problem when it results in Post Traumatic Stress Disorder (PTSD). Eight percent of women and four percent of men have PTSD, and over fourteen percent of veterans in the Iraqi conflict came home with PTSD, so you’re not alone by any means.[1,2] Unfortunately, anti-anxiety and anti-depressant medications aren’t very effective for PTSD and come with many side effects. However, in recent years Ketamine-Assisted Psychotherapy shows promise in clinical trials for PTSD and other anxiety related disorders.

How Does Ketamine Treatment for PTSD Work?

Ketamine has been used in battlefield and emergency medicine since the 1970’s. It’s powerful anesthetic properties allow for deep sedation and pain relief with a rapid onset. But, it wasn’t until the last decade that ketamine treatment for PTSD was researched.

Here’s what’s relevant to you specifically…

Ketamine has an immediate effect on certain PTSD symptoms such as depression, anxiety and suicidal thinking. Clinical trials have demonstrated that suicidal thinking can go away within just one treatment of ketamine, which many individuals with PTSD suffer from. Additionally, few medications, if any, really generate a significant impact for people who suffer from PTSD.

PTSD research suggests that low levels of a key hormone called “Brain-Derived Neurotrophic Factor” (BDNF) is a part of PTSD and that reversing low BDNF should help PTSD.[3]  Ketamine enhances neuroplasticity by significantly increasing Brain-Derived Neurotrophic Factor,[4] which can promote reversal of the loss of connectivity between neurons caused by chronic PTSD. Second, ketamine blocks receptors for glutamate[4], a neurotransmitter associated with brain excitotoxicity and inflammation which can also be a problem in PTSD.

How Effective are Ketamine Infusions for PTSD?

Effective medication interventions for PTSD have been very limited. Often, individuals with PTSD take anti-anxiety medications for panic attacks. Anti-anxiety medications work great for very short-term, acute situations. But they can become addictive and not get to the source of the problem.

A New Type of Therapy For PTSD: Ketamine-Assisted Psychotherapy

The handful of PTSD ketamine clinical trials to date generally provided one IV ketamine treatment to individuals with treatment-resistant PTSD. These studies report a significant and rapid reduction in symptoms of PTSD.[5] No treatment for PTSD has ever shown this rapidity of efficacy. The Dore et al (2019) study of Ketamine-Assisted Psychotherapy also reported significant efficacy for participants with PTSD.[6]

Ketamine for PTSD Clinical Trials

In 2014, a randomized controlled trial of IV Ketamine reported a significant decrease in PTSD symptoms.[5] This study is important because it shows how quickly PTSD symptoms can drop after an IV ketamine session.

Figure: Feder at al 2014

Ketamin for PTSD

  • Personal Outcomes

    Visualize a life where you feel safe to go outside, calm in your own body and grateful for your friends and family. Wouldn’t it be amazing to be able to fall asleep peacefully at night and wake up feeling refreshed in the morning ready to greet the day? Many IPC patients who have PTSD report this type of change after completing our Ketamine-Assisted Psychotherapy program. Even more exciting is that patients who were suffering from suicidal ideation often report feeling more hopeful about life and not pestered but these troublesome thoughts. If you’ve tried other therapies for PTSD and you’re not getting better, Ketamine-Assisted Psychotherapy may be the answer for you.

How We Are Different

Choosing a medical provider can be a stressful experience. We want to help you find the right ketamine provider for your needs. Although there are an increasing number of places offering ketamine, there are several key things that make our clinic different which are important to consider when determining if IPC is the right place for your care:

  • Medical Team:
    Our medical team is one of the most experienced groups of ketamine providers in the country.
  • Investment:
    At IPC we understand that patients who choose to pursue Ketamine Assisted Psychotherapy are making a significant financial investment in their long term health and we take that seriously. We are committed to keeping our costs as affordable as possible without compromising any aspect of the quality of care. We do not take medicaid, medicare or insurance, however, we can provide out-of-network claim forms if you want to seek reimbursement.
  • Integrative Psychiatry:
    Our clinic believes in assessing and treating root causes of mental health conditions. Unlike most ketamine clinics, you will be evaluated for your ketamine consult by an Integrative Psychiatrist. Rest assured, if we believe ketamine is not the right or only course of action, you will be recommended other treatments that go after the root of the problem.
  • Ketamine-Assisted Psychotherapy:
    Ketamine’s dissociative effects offer a unique opportunity to uncover new ways of understanding your depression. Most ketamine centers place multiple patients in one room without any psychotherapist. We have treated a number of people who felt very disturbed by the experience of being left alone on ketamine. Each patient in our clinic has a private room and a highly skilled therapist throughout the ketamine treatment. 

  • Physician On Site:
    Some ketamine centers do not provide a physician on site. Additionally, there are therapists who will provide psychotherapy for clients in their office who have received sublingual ketamine without medical staff present, even though the FDA recently mandated that a newly approved version of ketamine cannot be administered outside of a medical office. Although medical emergencies are an extremely rare outcome of ketamine, we stand firmly for safety first by having a physician and nurse on-site, and we do not condone the use of ketamine outside a medical office setting.
  • IV Ketamine:
    There are several different ways of administering ketamine and at IPC we prefer IV infusion because it is the most studied route of administration. If for some reason IV is not best for a specific individual we also have other routes of administration which can be discussed between a patient and their individual provider. Unfortunately, sublingual ketamine research is not compelling and scant, therefore, we do not generally recommend this route of administration.

Powered by the Integrative Psychiatry Institute

We’re not only on the forefront of integrative care for patients, but we are also backed by the educational power of the Integrative Psychiatry Institute. Our expert practitioners are learning directly from the premier educational community for integrative psychiatry. Rest assured, our practitioners are constantly implementing new practices from the latest research in innovative mental health care.

References:

1. Kessler, R.C., Berglund, P., Delmer, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6): 593-602.
2. Tanielian, T. & Jaycox, L. (Eds.). (2008). Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Santa Monica, CA: RAND Corporation.
3. Angelucci F, Ricci V, Gelfo F, et al. BDNF serum levels in subjects developing or not post-traumatic stress disorder after trauma exposure. Brain Cogn. 2014;84(1):118‐122. doi:10.1016/j.bandc.2013.11.012
4. Huang YJ et al. New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plast. 2017; 2017:4605971.
5. Feder A, Parides MK, Murrough JW, et al. Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2014;71(6):681–688. doi:10.1001/jamapsychiatry.2014.62
6. Jennifer Dore et al. Ketamine Assisted Psychotherapy (KAP): Patient Demographics, Clinical Data and Outcomes in Three Large Practices Administering Ketamine with Psychotherapy, Journal of Psychoactive Drugs, 51:2, 189-198, DOI: 10.1080/02791072.2019.1587556.