New study demonstrates that with repeated doses of IV ketamine, relief can last up to several weeks.
A deep unfamiliar voice behind Sarah made her jump. In a flash, she turned and bolted down the stairs she’d been climbing, turned left, then left again, knocking into people in her path as she scrambled for a place to hide. A mad dash took her into the restroom, where she locked the door and turned off the lights to hide in the dark. Screams sounded as darkness enveloped the room. Her heart was pounding, sweat pouring from her scalp, down her face, her torso…her armpits. She willed her breathing to slow…so the man pursuing her would not hear her panting gasps. (Poor Sarah. She’s suffering… if only she knew what repeated ketamine infusions relieve…)
Three women exploded out of their stalls complaining about the lights and searching for the switch. Sarah pushed past them to an empty stall and stood on the toilet seat with the door locked so her feet couldn’t be seen below the door.
Sarah’s vision blurred as sweat poured into her eyes. With a quick swipe, she wiped the moisture from her eyes and forehead. And waited. Silently.
By her watch, she saw time passing. She heard women come and go from the restroom…heard their quiet conversation… but she waited, hands trembling.
After 45 minutes crouched with feet on the toilet seat…Sarah began to feel calmer. It washed over her that she’d been hiding in a public restroom for close to an hour… and now she was late to work.
PTSD is Not Only Terrifying, It Seriously Interferes with Daily Living
Again.
Oh noooo.
Reality settled in. After washing her hands without incident, she cautiously opened the door and saw nothing unusual outside the door. She began to realize that it had happened again. Like countless other times. The sound of that voice triggered her memory of the assault…and it was so real. Except it wasn’t.
She was surrounded in the trauma again.
And that was the problem. Yet again, she would clock in late and be reprimanded for it. There must be help to conquer the PTSD symptoms that had emerged after she was assaulted 2 years ago. She had to find peace. Sarah wanted her life back.
Desperately.
Repeated Ketamine Infusions Relieve PTSD Under Controlled Conditions
PTSD can be so entrenched that it is very difficult to relieve — even with therapy, special trauma-based therapies, SRI’s, or a combination of approaches. Very early work with ketamine–and the brilliant neuroscientists behind those studies–showed ketamine could reduce PTSD symptoms.
A recent study from the Icahn School of Medicine at Mt. Sinai published January 5, 2021 has made splashing news among ketamine researchers and clinicians as the first randomized, double blind, placebo-controlled trial of repeated ketamine infusions for chronic PTSD. Adriana Feder and her team deserve applause and admiration, and have just set the bar higher for ketamine clinical trials.
It was brilliantly conceived, elegantly executed. Well done.
Patients with chronic PTSD that had gone on for years, from a variety of traumas, were separated into two groups. One group received 6 ketamine infusions (3 times a week over 2 weeks); the other group received an infusion of midazolam, which was the “placebo” in the trial, but it is was an active placebo–it made them feel something but it wasn’t ketamine.
Ok, now this is important: if you have PTSD, or if someone you love has PTSD, you want it to stop. That would be remission, and that would be ideal. But in the world of PTSD clinical research studies, researchers look for response, and response means a 30% decrease in your symptoms.
That’s how response is defined, and that’s how it was defined for this study: 30% improvement. It doesn’t seem like a lot of improvement, does it? Unless your life is a nightmare. Then a 30% reduction is a lot of improvement.
As it happened, 67% of those in the ketamine group responded after 6 infusions … compared to only 20% of those getting the placebo study drug.
A significant difference.
And possibly even more exciting than that 67%, those who received ketamine infusions experienced significant improvements across 3 of the 4 PTSD symptom clusters: intrusions, avoidance, and negative alterations in cognitions and mood.
So, Repeated Ketamine Infusions Relieve PTSD
Dr. Feder and her team — and all of us, truly — are encouraged by this kind of outcome, and of course, call for more infusion studies using more infusions as well as trials using ketamine infusions combined with trauma-focused therapy. In fact, we can and are imagining all kinds of studies we’d like to see for PTSD — different infusion parameters, different infusion doses, titrated infusions, new medications, new therapies. The GREAT news is that relief for PTSD is under investigation and more effective treatment is on the horizon.
Formal Studies Help to Establish Credibility
Now, it’s important to note that for a study to be replicable, it’s required to use clear protocols and consistent dosing. In real world practice, we have the duty and the responsibility to treat each patient as an individual for the best possible outcome. Sometimes that means using a teeny, tiny dose, tinier that you would imagine; sometimes it means titrating the dose to get a better response.
Medicine is a science and an art.
Since we’ve learned that effective depression relief requires different treatment for different patients, and effective ketamine treatment often requires different ketamine doses for different patients (and different conditions), we might expect the same to be true for PTSD.
The ketamine dose for each of the 6 infusions dose in this study was 0.5 mg/kg — the same dose used in the single-dose and early repeat-dose studies of treatment resistant depression.
But we find clinically, and from our own published work, many patients with depression need higher doses to stop suicidal thoughts, to achieve remission, and to restore hope.
By the way, notice that in the trial above, 67% of participants benefitted from ketamine infusions: they experienced a 30% drop in their symptoms. Ketamine is wonderful for those it helps — when it helps — but for reasons we don’t fully understand yet, it doesn’t help everyone. And it didn’t benefit everyone in the study. Ketamine is not a treatment that works for everyone. There isn’t anything that works for everyone.
In real life practice, we can titrate. By that I mean that we use our expertise, in addition to evidence-based scientific results, to adjust the infusion dose during treatment (within certain parameters) to try to bring forth the most effective results for you.
Because your treatment, of course, is about you. It’s all about you.
New Studies, like this one with a Series of Ketamine Infusions for PTSD, build our Brain Trust about Ketamine so that We Can Provide More Relief to More People Who Need It
One size may fit many, but not most, and one size never fits all.
At Innovative Psychiatry, we treat PTSD with repeated titrated IV ketamine treatment. And we use our deep expertise with ketamine in psychiatry and in the treatment of trauma to give you the best possible results. We’re thrilled that randomized, controlled trials are now investigating this so carefully. Research underscores safety, efficacy, and credibility. The more researchers learn, the more we can help you.
If you’ve suffered with PTSD and other treatments and medications have not helped, repeated ketamine infusions may help remarkably.
And remember, until the COVID-19 pandemic has moved to another solar system (just kidding! — but wouldn’t that be great?), we’re prepared to keep you safe when you’re here with us. We have the technology to keep the SARS-CoV-2 out of the air, and off of the surfaces in our office. We’re vaccinated, we’re tested regularly, we screen everyone. (And we keep the front door locked!) When you come for treatment, you can breathe easy.
We want you safe, and we want you relieved of PTSD and other symptoms.
Because, like Sarah, you need a life that is free to develop. A life that’s not interrupted with unmanaged symptoms.
And we want that life for you.
So you can follow your own dreams, and build the life you want to build.
If you suffer from PTSD and nothing has helped, call us.
In fact, if you suffer from treatment resistant depression, bipolar depression, anxiety, suicidal thinking and nothing has helped, call us.
Let us work with you to help you transform and enjoy your life.
To the restoration of your best self,
