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.

The struggle against PTSD, depression, anxiety, and TBIs is a complex one with no one-size-fits-all solution. However, the emergence of treatments like ketamine offers renewed hope. As we work to improve mental health care and support for veterans, the potential of this unique medication deserves our attention and further investigation. In the military, we’re trained to adapt, overcome, and utilize the tools at our disposal to achieve our mission. In the mission against mental health disorders and TBIs, ketamine might just be the unexpected ally we need.

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References

Newport, D. J., et al. (2015). “Ketamine and Other NMDA Antagonists: Early Clinical Trials and Possible Mechanisms in Depression.” American Journal of Psychiatry. https://pubmed.ncbi.nlm.nih.gov/26221052/ ↩

Berman, R. M., et al. (2000). “Antidepressant effects of ketamine in depressed patients.” Biological Psychiatry. https://pubmed.ncbi.nlm.nih.gov/10686270/ ↩

Feder, A., et al. (2014). “Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder: A Randomized Clinical Trial.” JAMA Psychiatry. https://pubmed.ncbi.nlm.nih.gov/24806638/ ↩

Himmelseher, S., & Durieux, M. E. (2005). “Revising a Dogma: Ketamine ↩