Ketamine as treatment for post-traumatic stress disorder: a review

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Abstract

Post-traumatic stress disorder (PTSD) continues to make headlines given multiple military engagements across the world and civilian traumas, and resultant PTSD development continues at an even pace. Currently, antidepressant and cognitive-behavioral therapy have the greatest evidence base but still do not yield a remission of PTSD symptoms in many patients. Off-label and novel treatments continue to be considered for more refractory and disabling cases of PTSD. Ketamine is one such treatment that has been discussed and utilized more often for treatment-resistant major depressive disorder (MDD). Its mechanism is controversial regarding its potential to create anxiety, but the perceived benefit of a rapid reduction of symptoms makes it worthy for study in animal models of, and possibly human studies in, PTSD. The current literature and theoretical mechanism of action is discussed in this manuscript.

Keywords: acute stress, brain-derived neurotropic factor, ketamine, N-methyl-D-aspartate, off-label use, post-traumatic stress disorders, psychological substance-related disorders, receptors, stress disorders, traumatic.

Citation: Liriano F, Hatten C, Schwartz TL. Ketamine as treatment for posttraumatic stress disorder: a review. Drugs in Context 2019; 8: 212305. DOI: 10.7573/dic.212305

Contributions: All authors contributed equally to the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors are available for download at https://www.drugsincontext.com/wp-content/uploads/2019/03/dic.212305-COI.pdf

Acknowledgements: Felix Liriano is a third year medical student.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2019 Liriano F, Hatten C, Schwartz TL. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0, which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2019 Liriano F, Hatten C, Schwartz TL. https://doi.org/10.7573/dic.212305. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://drugsincontext.com/ketamine-as-treatment-for-post-traumatic-stress-disorder:-a-review

Correspondence: Thomas L Schwartz, Psychiatry Department, SUNY Upstate Medical University, 713 Harrison Street, Syracuse, NY 13210, USA. schwartt@upstate.edu

Provenance: submitted; externally peer reviewed.

Submitted: 25 January 2017; Peer review comments to author: 16 May 2017; Revised manuscript received: 21 February 2019; Accepted: 27 February 2019; Publication date: 8 April 2019.

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