Online Ketamine Treatment Available in: AZ, CA, CO, FL, GA, NY, OR, TX, and WA.
Online Ketamine Treatment Available in: AZ, CA, CO, FL, GA, NY, OR, TX, and WA.
For many people living with post-traumatic stress disorder, standard treatments — including trauma-focused psychotherapy and SSRIs — provide incomplete relief. Studies estimate that 30% to 50% of PTSD patients do not achieve remission with first-line approaches. When nightmares, hypervigilance, and emotional numbness persist despite treatment, the question becomes: what else is available? A 2014 randomized clinical trial offered an important data point.
In a study published in JAMA Psychiatry in 2014, Adriana Feder and colleagues at the Icahn School of Medicine at Mount Sinai conducted a randomized, double-blind, crossover trial comparing intravenous ketamine (0.5 mg/kg) to midazolam (an active placebo) in 41 patients with chronic PTSD. Midazolam was chosen as the comparator because it produces sedation and mild psychoactive effects, making it harder for participants to guess which drug they received — a methodological strength over simple saline placebo.
The primary outcome was reduction in PTSD symptom severity, measured by the Impact of Event Scale–Revised (IES-R), 24 hours after infusion. Ketamine produced a significant reduction in PTSD symptoms compared to midazolam, with rapid onset of effect. Patients also showed significant improvement in comorbid depressive symptoms. The effect was evident within 24 hours and, for some participants, persisted for up to two weeks.
This was one of the first controlled trials to examine ketamine specifically in a PTSD population, and the results suggested that the same glutamatergic mechanism that underlies ketamine's antidepressant effects may also be relevant to the neurobiology of trauma. PTSD involves disruptions in fear circuitry, memory reconsolidation, and prefrontal-amygdala connectivity — all processes that glutamate signaling and synaptic plasticity may influence.
From a clinical standpoint, the Feder trial is significant for several reasons. First, the patient population had chronic, well-established PTSD — not recent-onset symptoms. These were patients who had been suffering for years and who had not responded adequately to other treatments. The rapid improvement observed with a single dose of ketamine suggests a biological mechanism distinct from what SSRIs or even trauma-focused therapy can achieve in the short term.
Second, the use of midazolam as an active control addresses one of the key criticisms of ketamine research — that patients can tell they're receiving an active drug because of its dissociative effects. While blinding is never perfect in psychoactive drug trials, midazolam is a reasonable comparator that strengthens the evidence.
If you are living with PTSD and have found that standard treatments haven't provided sufficient relief, the evidence suggests that ketamine may offer a different pathway to symptom reduction. It is not a cure, and it is not FDA-approved for PTSD. But the clinical data indicates that ketamine may reduce the intensity of PTSD symptoms rapidly, which can create a window for other therapeutic work — including psychotherapy — to take hold.
Many patients pursuing ketamine for trauma-related conditions pair their sessions with ongoing therapy, using the period of symptom relief and enhanced neuroplasticity as an opportunity to process difficult memories with greater emotional flexibility.
The Feder 2014 trial demonstrated that a single dose of ketamine may significantly reduce PTSD symptoms within 24 hours in patients with chronic, treatment-resistant PTSD. While larger studies are needed, this evidence supports ketamine as a promising option for patients who have not responded to conventional trauma treatments.
Reference: Feder A, Parides MK, Murrough JW, et al. "Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial." JAMA Psychiatry. 2014;71(6):681-688. PMID: 24806211
If you're considering ketamine therapy, Isha Health offers physician-led at-home treatment via telemedicine in California, New York, Texas, Florida, Colorado, Arizona, Georgia, Oregon, and Washington. No in-person visit required.
