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Review
. 2024 Feb;21(1):22-31.
doi: 10.36131/cnfioritieditore20240102.

Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis

Thales Marcon Almeida  1 , Ursula Raianny Lacerda da Silva  2 , Jeully Pereira Pires  2 , Isaac Neri Borges  2 , Clara Rosa Muniz Martins  2 , Quirino Cordeiro  1 , Ricardo R Uchida  1
Affiliations
Review

Effectiveness of Ketamine for the Treatment of Post-Traumatic Stress Disorder - A Systematic Review and Meta-Analysis

Thales Marcon Almeida et al. Clin Neuropsychiatry. 2024 Feb.

Abstract

Objective: 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.

Method: 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.

Results: 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.

Conclusions: 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.

Keywords: PTSD; ketamine; meta-analysis; post-traumatic stress disorder; systematic review.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1.
Figure 1.
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only
Figure 2.
Figure 2.
Forest Plot for Mean Difference in PCL-5 score, 24 hours after ketamine infusion for intervention and control groups, respectively
Figure 3.
Figure 3.
Forest Plot for Mean Difference in baseline PCL-5 score and at the endpoint ketamine treatment for intervention and control groups, respectively
See this image and copyright information in PMC

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