A new meta-analysis indicates that ketamine may be a beneficial treatment for post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD). The study, led by Angela T.H. Kwan, MD, from the Brain and Cognition Discovery Foundation, suggests that ketamine consistently reduces symptom severity in affected individuals.
The meta-analysis, which included 37 studies, examined the efficacy of ketamine across multiple mental disorders, excluding mood disorders. The trials included participants aged 18 years and older, assessing ketamine's impact on conditions such as alcohol use disorder, PTSD, substance use disorders, eating disorders, borderline personality disorder, and schizophrenia spectrum disorder. The routes of administration varied, including oral, subcutaneous, intramuscular, and intravenous.
Key Findings on PTSD and OCD
The analysis revealed statistically significant therapeutic effects for PTSD, as measured by the PTSD Checklist for DSM-5 (pooled estimate, -28.07; 95% confidence interval [CI], -40.05 to -16.11; P < .001) and Clinician-Administered PTSD Scale for DSM-5 scores (pooled estimate, -14.07; 95% CI, -26.24 to -1.90; P = .023). Significant therapeutic effects were also observed for individuals with PTSD, treatment-resistant PTSD, and OCD based on Yale-Brown Obsessive Compulsive Scale scores (pooled estimate, -8.08; 95% CI, -13.64 to -2.52; P = .004).
Impact on Alcohol Use Disorder and Other Conditions
The study also highlighted a reduction in the urge to drink, increased abstinence rates, and longer time to relapse among individuals with alcohol use disorders following ketamine treatment. Additionally, ketamine improved symptom severity in cocaine dependence/cocaine use disorder and anxiety disorders.
Limitations and Future Directions
Despite these promising results, the researchers noted that the studies primarily measured the acute effects of ketamine treatment. "Notably, these studies only measured the acute effects of ketamine treatment, so further study should be performed to establish efficacy and safety for long-term usage, as well as in repeat ketamine infusions," the investigators wrote. They also pointed out the heterogeneity across studies focusing on PTSD (P < .0001), treatment-resistant depression (P < .0001), and OCD (P = .02), and the lack of data on ketamine's efficacy and safety in real-world settings.
Conclusion
"Overall, the current evidence suggests that ketamine has transdiagnostic efficacy and safety across many mental disorders," the investigators concluded. However, they emphasized the need for more randomized controlled trials to fully understand ketamine's potential in treating psychiatric disorders beyond major depressive disorder.
