Everything You Need to Know About Ketamine for PTSD

As more public attention and awareness is given to psychedelic therapy, ketamine treatment, and similar healing modalities – these are often presented as powerful tools for healing trauma and its related effects.

Untreated or unhealed trauma is a core driver of developing post-traumatic stress disorder (PTSD), so much so that it is in the name of the diagnosis. 

There are several aspects of psychedelic medicines, and ketamine treatment in particular, that make these compounds and programs uniquely suited to help individuals manage and heal their PTSD as well as the underlying trauma(s) that contribute to them. 

UNDERSTANDING PTSD/cPTSD

Post-traumatic stress disorder (PTSD) is a diagnosis given to a cluster of symptoms and characteristics, often following an intense, acute, traumatic event in the individual's life. Complex-PTSD (cPTSD) is a diagnosis given when there are several traumatic events, or the trauma was sustained over the span of days, weeks, months, or years. 

PTSD can affect anyone, from children, adults, military veterans, and everyone in between. Ongoing studies and research into the best healing modalities for PTSD are providing promising results, but we are still moving towards a comprehensive treatment protocol for those living with the aftermath of traumatic events and PTSD. 

Healing and managing PTSD is often a battle fought on two fronts: working with the core traumatic experience, but also managing the physical and mental toll it takes afterwards. Individuals can become sensitive to triggers, develop one or several comorbidities, and develop maladaptive patterns of behavior in order to cope with the emotional and physical intensity of unresolved trauma. 

Ketamine treatment is being studied as a potential healing modality for PTSD, and early results are demonstrating remarkable safety, efficacy, and accessibility of this for a variety of clients living with PTSD. 

KETAMINE TREATMENT AVAILABILITY FOR PTSD

Ketamine is currently listed as a Schedule 3 substance by the DEA. This means that it is available for prescription by a licensed clinician. When used for treatment of mental health conditions like PTSD it is being used off-label. Off-label prescription means that under discretion, ketamine can be prescribed for conditions other than what it was originally approved for.

Ketamine is currently prescribed for a variety of anxiety and depression conditions. PTSD is not currently recognized as a direct treatment outlet, though there are several studies, as well as several organizations, conducting research in this area, and seeing promising results.

However, anxiety and depression conditions are very common comorbidities that often accompany PTSD in an individual, and ketamine can be prescribed to treat them. While it may be necessary to begin a course of treatment directly focused on managing the anxiety and/or depression conditions that accompany PTSD, the psychedelic & psychological aspects of the ketamine experience mean you will most likely be doing some work to address the root trauma of the PTSD as well. 

As continued research and clinical studies for ketamine treatment and psychedelic therapy continue, we expect to see PTSD rise to a full-fledged treatment addressed via ketamine therapy. 

PTSD is not currently an exclusion criteria nor contraindication, so it is best to speak directly with a clinician if you would like to explore the possibility of using ketamine treatment to help address and heal PTSD. 

BENEFITS OF KETAMINE TREATMENT FOR PTSD

Due to the phenomenological and neurobiological effects of ketamine, it is demonstrating a unique and remarkable ability to be a powerful healing modality for clients living with PTSD and its associated comorbidities. 

Several factors contribute to ketamines efficacy when dealing with deeply rooted and complex healing challenges such as those presented in PTSD. These include: 

1. DIRECTLY TREATING COMMON COMORBIDITIES

While PTSD arises from an acute, traumatic event – it is common to see cases of PTSD that have other comorbidities associated with it. 

These can include anxiety, depression, substance-use disorder, obsessive-compulsive tics and patterns of behavior, as well as day-to-day challenges with emotional management, dissociation, social withdrawal, and more. 

While there are many studies underway that look at the efficacy of ketamine treatment for PTSD directly – there are dozens of excellent studies with decades of clinical demonstration helping clients with most or all of the aforementioned comorbidities. 

Ketamine has been demonstrated to be a powerful healing modality for anxiety, depression, substance-use disorder, OCD, and more. Given this, ketamine treatment can greatly help reduce the acute and long-term suffering of clients by directly addressing several of the major challenging comorbidities that often accompany a PTSD diagnosis. 

In helping manage and mitigate these comorbidities, ketamine treatment can help clients gain more solid ground and increase their emotional resilience so that they can continue to do the important healing work addressing the core traumatic experiences that have created the PTSD to begin with.

2. NEUROBIOLOGICAL & PHYSIOLOGICAL HEALING

While the psychological healing of the traumatic experience is essential for resolving PTSD, ketamine offers a second strong benefit when working with PTSD by helping heal the physiological manifestations of the trauma. 

From increasing brain-derived neurotrophic factor (BDNF), increasing neuroplasticity, increasing neuronal health, and helping to discharge residual stress, tension, and triggers in the body – ketamine treatment compliments the psychological healing with physiological, body and brain level healing. 

Trauma affects an individual's psychology greatly, trauma also impacts and changes the physical brain and the body. A complete resolution of trauma must address both the psychological and the physiological domains – something that ketamine treatment does remarkably well. 

To speak metaphorically, ketamine treatment creates fertile ground in the brain and body that seeds of long-lasting psychological healing and wholeness are planted in. 

They work synergistically together, helping an individual make lifestyle changes easier and with more success, build emotional resilience to directly revisit the traumatic memories and rewrite these narratives and experiences into more empowering stories for themselves.

3. REFRAMING & HEALING THE CORE TRAUMATIC EXPERIENCES

One of the core challenges that arises when working to heal trauma and PTSD is the ability to revisit, reframe, and properly situate the traumatic experience within the historical arc of an individual's life. 

Simply revisiting the traumatic experience can be a challenge, as it often brings up very strong and visceral emotions, which can cause the individual to shut down, become angry/upset, or turn away from visiting the experience. Once an individual is able to revisit the memory, then begins the work of exploring the experience, reframing it, and helping situate it as another part of the individual's life, instead of the overpowering and highly charged experience it often lives at. 

This is another area that ketamine treatment is uniquely beneficial for individuals living with PTSD. The ketamine medicine experience is two-fold: it acts both as a dissociative, and shares many similarities with the psychedelic experience. Both are powerful at helping reframe and revisit emotions. Dissociation provides a sense of mental/emotional ‘distance’ from the experience, helping reduce the emotional charge, and let the individual take a novel perspective on the experience. Psychedelic experiences prove very useful for finding new and novel connections, reframing experiences into empowering ones, and situating memories and moments into their appropriate place in an individual's life. 

4. INCREASED NEUROPLASTICITY & BASELINE MOOD ELEVATION

In addition to the above benefits, over the course of a ketamine treatment protocol, ketamine provides a 10-14 day period after each dosing session with increased mental flexibility, a baseline mood elevation, and neurobiological healing. 

All of these help individuals continue to explore traumatic experiences, make positive lifestyle changes, and help those changes settle in more strongly and effectively than they would otherwise. 

Most ketamine treatment protocols have a number of medicine sessions included, anywhere from 1-6+. This gives the individual several weeks of increased neuroplasticity, paired with baseline mood increases, and the physiological healing of the brain and body that we described above. While healing PTSD is difficult work no matter what, these benefits provide a strong foundation for the individual to do this work.

5. ACCESSIBLE WHILE ON COMMON PSYCHOTROPIC MEDICATIONS

A final and less discussed benefit of ketamine treatment for PTSD is that unlike many of the classical psychedelics, whose mechanism of action is within the serotonin system, ketamine works on the glutamate system. This makes it safer to take ketamine while remaining on SSRIs or other common mental health medications.

For individuals suffering from PTSD, and the comorbidities of anxiety, depression, and substance use disorder, it is common that they may be using one or several pharmaceutical medications to help manage these symptoms. These medications are contraindicated for most psychedelic compounds – meaning an individual would be unable to receive psychedelic medicine unless they were weaned off of these medications.

An advantage of ketamine treatment is that individuals can stay on their existing medications while receiving ketamine, and in fact, ketamine treatment may be able to help them reduce or entirely discontinue their pharmaceutical medications. 

HOW TO RECEIVE KETAMINE TREATMENT FOR PTSD

If you or someone you know is working to heal PTSD and any related symptoms, there are a number of outlets you can go to sign up for and receive ketamine treatment. 

As it is still a scheduled substance, all paths to ketamine treatment begin with a consultation with a clinician in order to assess your physical and mental health, treatment goals, and ability to receive ketamine treatment. 

It is likely that you would be able to find a physical clinic in your state, or you can take Mindbloom’s eligibility survey here to see if you qualify for our at-home ketamine treatment programs. 

It’s helpful to explore the various routes of administration to help determine the partner or organization you would like to work with. Beyond this, you can address any questions, comments, or concerns with the care team as you begin the registration process for treatment. If in doubt, it’s helpful to have any concerns addressed by a licensed care team.

KEY TAKEAWAYS

PTSD and cPTSD are challenging to live with, and the path to healing and wholeness is not always straightforward or easy. Ketamine treatment is being actively studied as a potential healing modality and is already available for off-label prescription for a number of common comorbidities of PTSD. 

Ketamine treatment presents a number of potential benefits for healing PTSD, including addressing several major comorbidities, the ability to receive treatment while on other medications, and its dual action in healing both the psychological and physiological impacts of trauma and PTSD. 

For those who have recently gone through a traumatic experience, ketamine is not recommended. This is because ketamine experiences can intensify/worsen trauma symptoms in the acute trauma phase. A clinician will determine if this applies to individuals with trauma in their background and make recommendations.

More scientific studies and clinical research trials are underway, and the existing science is promising. We hope to see ketamine continue to become recognized and available as a general mental health treatment, particularly for individuals seeking to heal PTSD and associated symptoms.