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Repeated intravenous (IV) ketamine infusions can reduce the severity of symptoms in individuals with chronic post-traumatic stress disorder (PTSD), and improvement is rapid and lasts for several weeks afterward, according to a study by researchers at the ICANN School of Medicine. On Mount Sinai.

The study, published Jan. 5 in the American Journal of Psychiatry, is the first randomized controlled trial of repeated administration of ketamine in chronic PTSD and suggests that it is a promising treatment for PTSD patients. . “Our findings shed light on the therapeutic efficacy of repeated ketamine administration in PTSD, which is an important next step in our efforts to develop new pharmacological interventions for this chronic and disabling disease, as many individuals are not adequately helped by available treatments,” said Adriana FEDER. , MD, associate professor of psychiatry at the ICANN School of Medicine at Mount Sinai and lead author of the study. “The data suggest that repeated IV ketamine is a promising treatment for people suffering from PTSD, and provide supporting evidence for future studies to determine how we can maintain a rapid and stable response over time.” Prior to the current study, Mount Sinai researchers conducted the first proof-of-concept randomized controlled trial of single-dose intravenous ketamine for PTSD, which demonstrated a significant and rapid reduction in PTSD symptoms.

First approved by the US Food and Drug Administration as an anesthetic in 1970, ketamine acts as an antagonist of the N-methyl-d-aspartate (NDMA) receptor, an ionotropic glutamate receptor in the brain. In contrast, widely used antidepressants target different neurotransmitters—serotonin, norepinephrine, and dopamine—and can last for weeks to months. These drugs are considered ineffective in at least one-third of cases and only partially effective in another third. “The data presented in our current study not only replicates but also builds on our initial findings on ketamine for PTSD, which show that in addition to its rapid effect, ketamine can persist for several weeks. PTSD is an extremely debilitating condition, and we are pleased that our discovery may lead to treatment options for many who need relief from their suffering,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs at Mount Sinai Health System and lead author of the paper. For this study, participants were randomized to receive six infusions of ketamine, given three times a week for two consecutive weeks, compared to six infusions of the psychoactive midazolam with a placebo. Those of ketamine) were administered and evaluated according to the same schedule.

Subjects in this study had severe and chronic PTSD from civilian or military trauma with a median duration of 14 years, and almost half of the sample were taking concurrent psychotropic medications. Major traumas reported by participants included sexual assault, harassment, physical assault or abuse, witnessing a violent attack or death, surviving or responding to the 9/11 attacks, and combat exposure. All study participants were assessed at baseline, week 1, and week 2, as well as on each infusion day by teams of trained study raters who administered the clinically administered PTSD scale for DSM-5 and the Montgomery-Asberg Depression Rating Scale (MADRS). Administered. , Standard Rating Scale for PTSD and Depression. More participants in the ketamine group (67 percent) achieved at least a 30 percent or greater reduction in symptoms from baseline after two weeks than in the midazolam group (20 percent). In addition, ketamine infusions were associated with significant improvements in three of four clusters of PTSD symptoms—intrusions, avoidance, and negative changes in cognition and mood.

In a sub-sample of ketamine responders, improvement in PTSD symptoms was rapid, observed 24 hours after the first infusion, and lasted an average of 27.5 days after the day of the primary outcome assessment. Furthermore, to improve PTSD symptoms, the ketamine group showed a greater reduction in comorbid depressive symptoms than the midazolam group, which is known to have high comorbidity of depression in individuals with PTSD. The study results further suggest that repeated infusions of ketamine are safe and generally well tolerated in individuals with chronic PTSD. “Further studies may include administering multiple doses over time and examining repeated infusions of ketamine in combination with trauma-focused psychotherapy to help us determine how to maintain this association. -op long-term response,” added Dr. Feder. “We want PTSD sufferers to know there is hope, and we are working diligently to gather information to help bring them the relief they need.” As explained, Dr. Charney and Feder are named co-inventors on and issued US patents and several issued non-US patents filed by the Icahn School of Medicine at Mount Sinai for the use of ketamine as a therapy for PTSD. This work was funded by a NARSAD Independent Investigator Award from the Brain & Behavior Research Foundation (PI Dr. Feder) through a generous gift from Mr. Gerald Greenwald and Mrs. Glenda Greenwald and Mount Sinai Innovation Partners through the i3 Accelerator, a $10 million fund that provides new discoveries at Mount Sinai with the investment needed to accelerate technology development to reach patients as soon as possible.

Additional funding for this study was provided by the Ehrenkranz Laboratory for Human Resilience, part of the Center for the Discovery and Treatment of Depression and Anxiety at ISMMS. Tags: Depression, Anxiety and Bipolar Disorder, Icahn School of Medicine at Mount Sinai, Dennis S Charney, MD, Adriana Feder, MD, Mount Sinai Health System About Mount Sinai Health System Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working in eight hospitals, more than 400 outpatient procedures, nearly 300 laboratories, a nursing school, and a leading medical school. And graduate education. Mount Sinai promotes health for all people, everywhere, by addressing the most complex health challenges of our time – discovering and applying new insights and knowledge to science; developing safer and more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by providing high-quality care to all who need it.

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