Repeated ketamine infusion can be a promising treatment for PTSD patients

Intravenous (IV) ketamine infusions again significantly reduce the depth of symptoms in individuals with post-traumatic stress disorder (PTSD) and their development is rapid and maintained for several weeks. subsequently, according to a study conducted by researchers from the Icahn School of Medicine at Mount Sinai. The study, published September XX in the American Journal of Psychiatry, this is the first randomized, controlled trial of repeated ketamine administration for chronic PTSD and suggests that this may be a promising treatment for PTSD patients.

Our findings provide us with an insight into the efficacy of ketamine re-administration treatment for PTSD, the next important step in our effort to develop modern pharmacologic interventions for this harmful and debilitating disorder, as a large number of individuals are not getting enough help with the treatments currently available. The data suggest that IV ketamine is again a promising treatment for people with PTSD and provide evidence support to warrant future studies to find out how we can sustain this swift and strong response over time. “

Adriana Feder, MD, Associate Professor of Psychology, Icahn School of Medicine at Mount Sinai and Lead Author of the Study

Prior to the current study, Mount Sinai researchers performed the first randomized controlled trial of a single dose of intravenous ketamine for PTSD, which showed a significant and rapid reduction in 24-hour post-infusion PTSD symptoms. Originally approved by the U.S. Food and Drug Administration as an anesthetic agent in 1970, ketamine acts as an antagonist of the receptor N-methyl-d-aspartate (NDMA), a ionotropic glutamate receptor in the brain. In contrast, widely used antidepressants target different neurotransmitters – serotonin, norepinephrine, and dopamine – and can take weeks to even months for action. These drugs are considered ineffective in at least a third of cases, and only partially effective in an additional third.

“The data presented in our current study not only reproduces, but also builds on our initial conclusions about ketamine for PTSD, showing that the effects of ketamine can be maintained out over several weeks as well as fast. PTSD is an extremely debilitating condition and we are pleased that our discovery could provide a treatment option for so many who need relief from their suffering, “said Dennis S. Charney , MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and Academic President of Affairs for the Mount Sinai Health System and senior author of the paper.

For the current study, participants were randomly assigned to receive six infusions of ketamine, administered three times a week over two consecutive weeks, compared with six infusions of the psychoactive placebo-controlled midazolam (selected by that its pharmacokinetic parameters and nonspecific behavioral effects are similar to those of ketamine) administered and evaluated over the same table. Individuals in this study had severe and chronic PTSD from civil or armed trauma, with a median duration of 14 years and nearly half of the sample taking concomitant psychotropic medications. The main traumas reported by participants included sexual assault on molestation, physical assault or abuse, witnessing a violent assault or death, surviving or responding to 9/11 attacks, and fight against. All study participants were assessed at baseline, at week 1 and week 2, as well as daily infusion by teams of trained study participants who administered the Clinical Administration PTSD Scale for DSM-5 and the Montgomery-Asberg Low Assessment Scale (MADRS), standard ranking scales for the assessment of PTSD and depression.

Many more participants in the ketamine group (67 percent) experienced at least a 30 percent or more reduction in symptoms from baseline at week two than those in the midazolam group (20 percent). In addition, ketamine ingestions were associated with marked improvements across three of the four aggregates of PTSD symptoms – satiety, abstinence, and negative changes in mood and mood. In the subset of ketamine respondents, improvement in PTSD symptoms was very rapid, was observed 24 hours after the first infusion, and was maintained for a median of 27.5 days after the day of assessment of the results. primary school. In addition to the improvement of PTSD symptom, the ketamine group showed a significantly greater reduction in comorbid depression symptoms than the midazolam group, which is notable for the high incidence of depression in individuals with PTSD. . Further study findings suggested that repeated ketamine infusion is safe and well tolerated in individuals with chronic PTSD.

“Future studies could include the administration of additional doses over time and the study of repeated infusions of ketamine in combination with trauma-focused psychotherapy, to help us to see how we can sustain this strong response in the long term, “said Dr Feder.” We want people with PTSD to know that there is hope ahead. and we are working hard to gather the information that will help them to give them the relief they so desperately need. “

Drs. Charney and Feder are named co-engineers on a patent issued in the United States, and several patents filed outside the U.S., filed by the Icahn School of Medicine at Mount Sinai for using ketamine as a treatment for PTSD.