Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis.
Thales Marcon Almeida, Ursula Raianny Lacerda da Silva, Jeully Pereira Pires, Isaac Neri Borges, Clara Rosa Muniz Martins, Quirino Cordeiro, Ricardo R Uchida
Clinical neuropsychiatry February 1, 2024 DOI: 10.36131/cnfioritieditore20240102 via PubMed
Summary
AI-generated from the abstractA systematic review and meta-analysis of ten studies (five randomized controlled trials, two crossover trials, and three non-randomized trials) examined ketamine's effectiveness for post-traumatic stress disorder. Ketamine led to significant improvements in PTSD symptoms measured by PCL-5 scores at the end of treatment courses lasting one to four weeks, with a standardized effect size of 0.25. However, no significant effect was found 24 hours after the first infusion. High heterogeneity across analyses limits confidence in the findings. The results suggest ketamine may be a promising treatment option, but more trials are needed to establish reliable evidence.
Study at a glance
| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Population | Adults with post-traumatic stress disorder |
| Intervention | Ketamine |
| Duration | 1 to 4 weeks |
| Topics | Ketamine PTSD |
| Keywords | Meta-analysis Systematic review Mental health PTSD Treatment |
| Citations | 20 |
| Key finding | Ketamine significantly improved PTSD symptoms at the end of treatment courses lasting one to four weeks, but not 24 hours after the first infusion, with a standardized effect size of 0.25. |
Abstract
Post-traumatic stress disorder (PTSD) is an enduring condition characterized by a chronic course and impairments across several areas. Despite its significance, treatment options remain limited, and remission rates are often low. Ketamine has demonstrated antidepressant properties and appears to be a promising agent in the management of PTSD. A systematic review was conducted in PubMed/MEDLINE, Cochrane Library, Clinicaltrials.gov, Lilacs, Scopus, and Embase, covering studies published between 2012 and December 2022 to assess the effectiveness of ketamine in the treatment of PTSD. Ten studies, consisting of five RCTs, two crossover trials, and three non-randomized trials, were included in the meta-analysis. Ketamine demonstrated significant improvements in PCL-5 scores, both 24 hours after the initial infusion and at the endpoint of the treatment course, which varied between 1 to 4 weeks in each study. Notably, the significance of these differences was assessed using the Two Sample T-test with pooled variance and the Two Sample Welch's T-test, revealing a statistically significant effect for ketamine solely at the endpoint of the treatment course (standardized effect size= 0.25; test power 0.9916; 95% CI = 0.57 to 17.02, p=0.0363). It is important to note that high heterogeneity was observed across all analyses. Our findings suggest that ketamine holds promise as an effective treatment option for PTSD. However, further trials are imperative to establish robust data for this intervention.