** Editor’s Note: This submission is from Sam Peterson, a good friend of SOFREP and veteran EOD technician with two combat deployments to Afghanistan under his belt.  Post-service, he has focused his attention on helping the mental health concerns of his fellow veterans. He does this at Mind Spa, a veteran physician let mental health clinic in the Denver, Colorado area. -GDM

Greetings, readers. Sam Peterson here, former EOD tech turned mental health professional. Today’s post, I want to focus on a unique potential ally in the struggle against PTSD, depression, anxiety, and traumatic brain injuries (TBIs) – Ketamine. Before we start, it is important to know that I am not a doctor, and this is not medical advice.

Historically known as a surgical anesthetic and unfortunately abused as a recreational drug, ketamine has recently been repurposed as a mental health treatment in clinical settings across the country. It has emerged as a promising therapeutic tool, particularly for treatment-resistant cases of depression, anxiety, and PTSD1. The most significant advantage of ketamine therapy is its rapid action. Traditional antidepressants typically take weeks to months to show their full effect. However, ketamine can reduce depressive symptoms within hours2, which is critically important for those grappling with severe conditions.

PTSD is another area where ketamine shows significant promise. A study conducted by Feder and colleagues3 demonstrated that a single infusion of ketamine resulted in significant, rapid-onset improvement in PTSD symptoms when compared to a placebo. Given the high incidence of PTSD among veterans, this fast-acting treatment offers hope for those battling the psychological aftermath of combat experiences.

Apart from its direct effects on mood disorders, ketamine’s anti-inflammatory properties could be leveraged to address another common issue combat veterans face – traumatic brain injuries. TBIs, caused by blows or jolts to the head, are a significant cause of disability among veterans. Inflammation plays a major role in the damage caused by TBIs. Emerging research suggests that ketamine’s anti-inflammatory effects can help minimize the harmful consequences of TBIs. Its neuroprotective properties could potentially alleviate symptoms and improve recovery outcomes in TBI patients5. Despite its potential, the use of ketamine in treating mental health disorders and TBIs is not without challenges. Its hallucinogenic side effects and the potential for misuse mean that its administration needs to be carefully managed under medical supervision. More extensive research is required to determine optimal dosing, administration methods, and long-term effects.

Now it’s important to mention that all ketamine administration methods are NOT created equal. Although intramuscular injections and intranasal administration (Esketamine/Spravato) are well-researched, they aren’t the best way to administer this drug. Why, you may ask? The reason is intensity and speed of onset. With both administration methods, the onset of dissociation, the feeling of being outside your body or disconnected from your sense of self, happens rapidly. Imagine getting shot into space on the tip of a rocket. With the above methods, the entire dose is delivered to the brain at once; which can lead to serious side effects, think dissociative panic attacks. No one wants that.

The preferred method of administration, at least at our clinic, is intervenous (IV) administration (link to our clinic page at the bottom of this post). With IV administration, instead of disassociating from our bodies at the speed of an F35 breaking the sound barrier, we go to that same space on an elevator. The nurse or other qualified clinical provider controls the dose and drip rate at all times, ensuring that the patients transition out of and back into their bodies in a controlled fashion. If the patient starts to have an adverse reaction or feels uncomfortable, the infusion can be slowed or stopped at any time.