Low dose oral ketamine treatment on post-traumatic stress disorder (PTSD) (OKTOP): An open-label pilot study
Bonnie L. Quigley, Adem T. Can, Megan Dutton, Cyrana C. Gallay, Grace Forsyth, Monique Jones, Fiona Randall, Trish Wilson, Jim Lagopoulos, Daniel F. Hermens
medRxiv Preprint Server November 26, 2024 preprint DOI: 10.1101/2024.11.26.24318024 via medRxiv
Summary
AI-generated from the abstractA weekly low-dose oral ketamine treatment for six weeks significantly reduced PTSD symptoms in adults with PTSD, many of whom also had depression. PTSD Checklist scores dropped from an average of 40 before treatment to 17 after treatment, and remained reduced at 21 one month later. 73% of participants showed at least a 50% reduction in symptoms after treatment, and 59% maintained that improvement at follow-up. The results suggest oral ketamine is a feasible and tolerable treatment option, comparable to intravenous ketamine, and may overcome limitations of IV administration.
Study at a glance
| Characteristics | Open-label pilot study Randomized |
|---|---|
| Sample size | 22 |
| Population | Adults aged 22-77 with PTSD, 55% female, 82% with comorbid depression |
| Intervention | Oral ketamine |
| Dose | titrated from 0.5 mg/kg to a maximum of 3.0 mg/kg |
| Duration | 6-week treatment course, 1-month follow-up |
| Topics | Ketamine |
| Keywords | Low-dose oral ketamine PTSD Treatment PTSD Therapy PTSD Relief Symptom reduction |
| Citations | 1 |
| Key finding | Low-dose oral ketamine administered weekly for six weeks significantly reduced PTSD symptoms, with a 73% response rate post-treatment and sustained improvement at one-month follow-up. |
Abstract
Ketamine is being actively investigated as a rapid-acting treatment for many conditions with a stress-related psychopathology, including post-traumatic stress disorder (PTSD). The majority of studies regarding ketamine treatment for PTSD to date (including open-label and randomised control trials) have focused on intravenous (IV) ketamine administration. This administration route has limitations that can be overcome with oral ketamine. As such, this study undertook the first open-label low dose Oral Ketamine Trial on PTSD (OKTOP) to determine the safety and feasibility of sub-anaesthetic ketamine for PTSD symptom reduction. Participants with PTSD (n = 22 adults, aged 22-77 years, 55% female, 82% with comorbid depression) followed a weekly treatment course of low dose oral ketamine (titrated from 0.5 mg/kg to a maximum of 3.0 mg/kg) for six weeks. The primary outcome measure was the PTSD Checklist (PCL-5), with secondary measures including scales for depression, anxiety, stress, suicidality, sleep, and wellbeing. Mean PCL-5 scores were significantly reduced from a pre-ketamine baseline score of 40 to a post-ketamine score of 17 and remained at a reduced score (21) at follow-up, 1-month post-treatment. This reduction resulted in a response rate (defined as a ≥50% reduction in PCL-5 score from baseline) of 73% post-ketamine and 59% at follow-up. This response rate is comparable with IV ketamine trials for PTSD and suggests oral ketamine administration is a feasible and tolerable treatment for PTSD.