Anxiety

Latest Literature on Benefits of Ketamine

Banov et al. (2019) discusses the potential use of ketamine in the treatment of anxiety and anxiety spectrum disorders. Despite various treatments available, there are still high rates of partial response and low rates of long-term remission in these conditions. The authors present limited but growing evidence to support the use of ketamine in anxiety disorders, including case reports, case series, and controlled trials. Its unique mechanism of action, rapid onset, and high response rate have driven its use in clinical practice. Ketamine is generally well-tolerated by patients with a limited side effect profile, but the long-term effects are still unknown. Further research is needed to determine its long-term safety and tolerability.

Whittaker et al. (2021) conducted a systematic review and meta-analysis of randomized controlled trials to investigate the effectiveness of ketamine in treating refractory anxiety spectrum disorders. Six acute RCTs were eligible, with two in social anxiety disorder, three in post-traumatic stress disorder, and one in obsessive-compulsive disorder. Preliminary analyses suggest that acute ketamine may have a broad effectiveness across treatment-resistant anxiety spectrum disorders, with a dose response profile observed for ketamine and changes in SAD symptoms. These effects can be prolonged with maintenance treatment.

Tully et. Al (2021) conducted a systematic review on the use of ketamine for refractory anxiety. Ketamine has fast-acting mood-enhancing and anxiolytic effects that persist for up to a week, making it a potential treatment for patients with refractory anxiety disorders. The role of NMDA receptors in anxiety reduction is not well understood. This review assesses the evidence on whether ketamine significantly reduces refractory anxiety and discusses the possible involvement of NMDA receptor antagonism and other receptors. The review also highlights the temporary nature of the anxiolytic effects and the high discrepancy among study designs regarding factors such as administration routes, complementary treatments, and other treatments.

Ragnhildstveit et al. (2023) reviewed clinical evidence on the potential use of ketamine in treating post traumatic stress disorder (PTSD). PTSD is a devastating condition with few effective pharmacological agents and limited availability of trauma-focused psychotherapies. Off-label interventions are often used in chronic, refractory cases. The review synthesized evidence from case reports, chart reviews, open-label studies, and randomized trials, indicating encouraging signals of therapeutic safety, efficacy, and durability. Although there is high heterogeneity in clinical presentation and pharmacological approach, avenues for future research are discussed.

Feder et al. (2021) conducted a randomized controlled trial on the efficacy of repeated ketamine administration for chronic posttraumatic stress disorder (PTSD). Participants who received ketamine showed significant improvement in CAPS-5 and MADRS total scores compared to those who received midazolam. Sixty-seven percent of participants in the ketamine group were treatment responders compared to 20% in the midazolam group. Among ketamine responders, the median time to loss of response was 27.5 days following the 2-week course of infusions. Ketamine infusions were generally well-tolerated without serious adverse events. The study provides the first evidence of the efficacy of repeated ketamine infusions in reducing symptom severity in individuals with chronic PTSD. Further studies are needed to fully understand the potential of ketamine as a treatment for chronic PTSD.

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Other useful articles

• Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder A Randomized Clinical Trial (2014)

• Ketamine’s dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders (2018)

• Safety and efficacy of maintenance ketamine treatment in patients with treatment-refractory generalised anxiety and social anxiety disorders (2018)

• Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial (2018)

• The emergence of ketamine as a novel treatment for posttraumatic stress disorder (2020)