Ketamine for Treatment of Posttraumatic Stress Disorder: State of the Field.

Focus (American Psychiatric Publishing) Pub Date : 2023-07-01 Epub Date: 2023-06-28 DOI:10.1176/appi.focus.20230006
Rachel Fremont, Oneysha Brown, Adriana Feder, James Murrough
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Abstract

Posttraumatic stress disorder (PTSD) is a chronic and debilitating condition. Although several psychotherapeutic and pharmacological treatments are recommended for PTSD, many individuals do not respond to treatment or respond only partially, highlighting a critical need for additional treatments. Ketamine has the potential to address this therapeutic need. This review discusses how ketamine emerged as a rapid-acting antidepressant and has become a potential treatment for PTSD. A single dose of intravenous (IV) ketamine has been shown to facilitate rapid reduction of PTSD symptoms. Repeated IV ketamine administration significantly improved PTSD symptoms, compared with midazolam, in a predominantly civilian sample of individuals with PTSD. However, in a veteran and military population, repeated IV ketamine did not significantly reduce PTSD symptoms. Further study of ketamine as a treatment for PTSD is necessary, including which populations benefit most from this therapy and the potential benefits of combining psychotherapy and ketamine.

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氯胺酮治疗创伤后应激障碍:领域现状。
创伤后应激障碍(PTSD)是一种使人衰弱的慢性疾病。尽管针对创伤后应激障碍推荐了多种心理治疗和药物治疗方法,但许多患者对治疗没有反应或仅有部分反应,这凸显了对其他治疗方法的迫切需求。氯胺酮有可能满足这一治疗需求。本综述将讨论氯胺酮是如何作为一种速效抗抑郁剂出现并成为创伤后应激障碍的一种潜在治疗方法的。研究表明,单剂量静脉注射氯胺酮可迅速减轻创伤后应激障碍症状。在以平民为主的创伤后应激障碍患者样本中,与咪达唑仑相比,重复静脉注射氯胺酮能明显改善创伤后应激障碍症状。然而,在退伍军人和军人群体中,重复静脉注射氯胺酮并不能明显减轻创伤后应激障碍症状。有必要对氯胺酮作为创伤后应激障碍的治疗方法进行进一步研究,包括哪些人群从这种疗法中获益最多,以及心理疗法与氯胺酮相结合的潜在益处。
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