Treating Post-Traumatic Stress Disorder in Canadian Special Operation Forces Command With Ketamine Plus Cervical Sympathetic Blockade.

Military medicine  – February 27, 2025

Source: PubMed

Summary

A promising new treatment combining ketamine infusion with nerve blocks reduced PTSD symptoms by 45 points in Canadian special forces operators. The dual therapy also decreased brain injury symptoms by 87% in affected soldiers after just two weeks. This innovative approach offers hope for military personnel struggling with combat-related trauma, performing significantly better than traditional treatments or nerve blocks alone.

Abstract

Canadian Special Operation Forces Command (CANSOFCOM) operators have been extensively deployed in recent conflicts. They are at risk of trauma and blast exposure as well as the development of post-traumatic stress disorder (PTSD) and blast traumatic brain injury (bTBI). Current psychotherapy and pharmacological approaches provide suboptimal resolution of PTSD and bTBI symptoms. Prior research has shown that ketamine infusion and cervical sympathetic blockade (CSB) have reduced PTSD and bTBI symptoms. A total of 11 patients, including CANSOFCOM members, were treated and followed. Pre- and post-intervention PTSD Checklist-5 and Neurobehavioral Inventory Scale (NSI) scores were recorded. Neurobehavioral Inventory Scale questionnaire was administered only to patients with a history of traumatic brain injury. Each patient received 4 ketamine infusion and bilateral CSB treatments, as per previously published by IRB protocol #00000971. Two weeks post-intervention, average PTSD Checklist score reduction of 45.09 (n = 11). Two weeks post-intervention, average NSI score reduction of 40.7 (87.0% reduction) (n = 6). No other NSI scores were available. These findings highlight the importance of early intervention and ongoing evaluation in PTSD treatment. Ketamine infusion combined with bilateral CSB can provide a clinically significant reduction of PTSD and bTBI in the CANSOFCOM cohort. Of interest, another study of CSB alone as a treatment of bTBI, which used NSI assessment, showed a reduction of 53% on a 1-month follow-up. Our report demonstrated an 87% reduction in NSI score at 2 weeks. Possible physiological explanations and study limitations are discussed.

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