How Do You Treat PTSD with Ketamine? Clinicians Weigh In
The treatment of PTSD with ketamine has come a long way since its FDA approval in the 1970s. Its potential for treatment of PTSD was discovered, incidentally, in the 1990s after its use in combat surgeries Later studies showed a reduction of PTSD incidents in soldiers receiving surgery with the use of ketamine as a dissociative anesthetic.
Since then, new studies have led to to exciting findings, including how ketamine changes the brain in those with PTSD. Additionally, veterans with PTSD saw a groundbreaking 80 percent remission rate when receiving ketamine treatment.
Not only have early studies shown ketamine to be effective at treating PTSD, but it works quickly. In fact, many patients experience a reduction in symptoms after a single treatment.
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With the increase of studies and news stories, it can be difficult to ascertain exactly how to treat PTSD with ketamine, while understanding what to expect if considering the treatment.
To help bring clarity, we’ve asked medical experts from across the country to share their thoughts and experiences on how to treat PTSD with ketamine.
Dr. Mike Cooper – Innerwell At-Home Ketamine Therapy
One of the most impressive effects of ketamine is its ability to facilitate neuroplasticity, which is essentially the brain’s ability to heal itself and form new pathways. If the brain is visualized as a ski slope, the neural pathways of patients with PTSD can be thought of as ingrained ski tracks that limit the freedom of thoughts, emotion, and behavior. After a ketamine journey these ski tracks get blanketed with fresh powder snow. This creates an opportunity to carve new tracks in the snow, or in other words, build new neural pathways. By building new neural pathways, patients with PTSD can finally experience relief from the fear, hypervigilance, avoidance, and depression that they had previously found so debilitating.— Dr. Mike Cooper, Medical Director of Innerwell At-Home Ketamine Therapy
Dr. Mike Cooper, M.D., is a board-certified psychiatrist and Medical Director at Innerwell.
Dr. Thomas Swahn – Swahn Balanced Health
We live our lives from the only vantage point available: looking out at the world from inside our own heads. The beautiful thing about the ketamine experience is that it zooms you out from yourself, providing you an opportunity to see things from a different perspective. Suddenly, the big picture is available, reminding us that there is beauty all around us and our problems are not the insurmountable obstacles we sometimes think they are when we’re too close to them. From the outside, it’s easier to see problematic areas and solutions may come easily. It’s incredible for PTSD because it wraps you in a blanket of serenity and logical acceptance that allows you to decouple your identity from past traumas, changing them from core personality features to merely a chapter in your story. Moving forward without problematic coping mechanisms becomes possible.— Dr. Thomas Swahn
Dr. Thomas Swahn started Swahn Balanced Health with his wife, Dr. Krissy Swahn, to bring the incredible transformation facilitated by ketamine therapy to their community. With a belief in ketamine’s healing powers, the Swahn’s fully understand how to treat PTSD with the emerging therapy.
Dr. Charles Henry Kirsch, MD – New Horizons Infusion Clinics
PTSD often presents as a layered and complex set of challenges for individuals experiencing it. Our patients have found incomplete resolution from their often debilitating symptoms from traditional therapies. At New Horizon we encourage continuation of pharmacotherapy and counseling while they receive ketamine infusions. Ketamine presents a pathway with unique qualities in our current healthcare ecosystem. Due to the nature of ketamine’s action on the brain, we often see improvement in a patient’s mental health more rapidly than most traditional modalities. It can enable the individual to obtain new perspectives in a few key ways. Some dissociation is often experienced which is likely causal to the change in perspective that frequently occurs. Intellectually, our patients often gain insight and new angles with which to comprehend their lived experience. Emotional challenges often become less severe quickly. This combination can allow for marked improvement in subjective well being and standardized metrics. We work with our patients to titrate the ketamine dosage progressively over a course of six initial hour-long infusions. Often, patients will return for a ‘booster’ infusion if they feel the effects waning. This may occur between one and three months after the initial series.— Dr. Charles Henry Kirsch, MD
Dr. Charles Henry Kirsch, MD is a physician at New Horizon Infusion Clinics in Tallahassee. He studied medicine at the Medical College of Georgia and has been working with alternative and emerging therapies to provide patients with effective options to treat their mental health concerns. His interests include natural medicines and the potential of psychoactive molecules to enable greater health and well being.
Sam Mandel – Ketamine Clinics Los Angeles
Ketamine Clinics Los Angeles treats PTSD with ketamine by providing a series of six IV infusions over the course of 2-3 weeks. Each infusion is 50-55 minutes long and is started at a rate of around .6mg / kg of body weight and titrated up or down depending upon the patient’s response. PTSD responds particularly well to ketamine compared to other mental health disorders. Patients are able to revisit trauma without being triggered by it or experiencing an emotional reaction in many cases, providing an opportunity to get closure, gain new insight, and work through details of their experience. Sometimes trauma has been so deeply suppressed that patients don’t even recollect it until it resurfaces during an infusion. This can be a very important healing opportunity. During an infusion, the reaction or response from patients varies widely; some patients laugh for a full hour, others cry non-stop, and most are on an inner journey that doesn’t manifest with any particular outward expression.
In addition to the psychological experience that patients have, the neurochemical response to ketamine that occurs in the brain helps to create new neural pathways. Old ways of thinking and being can be disrupted and replaced with newer, healthier thought patterns and connections in the brain. This can be vital in reframing the trauma of the past and parting ways with an old identity that no longer serves patients. An upgraded operating system is one way some people like to think of it. We strongly advocate for talk therapy and various other modalities, such as EMDR, for the continued healing from various types of trauma. A specialist who understands trauma, and the specific type of trauma any given patient may have, is a critical piece of the puzzle for patients suffering from PTSD to experience complete relief. Fortunately, ketamine is highly effective on its own and can relieve symptoms while providing energy and motivation for patients to pursue counseling and lifestyle optimization, both of which cement the relief the infusions provide. More than 80 percent of our PTSD patients benefit from infusions at Ketamine Clinics Los Angeles. Consultations are free of charge, so we encourage anyone who is interested in learning more to contact us today at firstname.lastname@example.org.— Sam Mandel, Cofounder & COO of KCLA
Sam Mandel is a lifelong mental health advocate and entrepreneur. Along with his father, Dr. Steven Mandel, Sam started KCLA in 2014 and has grown the clinic to be one of the most successful and well-respected ketamine infusion therapy clinics in the U.S. He is responsible for the day-to-day operations and strategic direction of KCLA and manages its growing staff of 18. He oversees all non-clinical functions, including patient satisfaction, HR, and employee retention, vendor relations, marketing, public relations, technology, and finance. When not in the clinic, Sam enjoys traveling, snowboarding, and weightlifting.
Dr. Marcel Green – Hudson Mind
For people living with PTSD, unrelenting flashbacks often block the healing process. Though ketamine does not wipe away memories of trauma, it does offer a means for disconnecting from the recurring thought patterns that hold the mind hostage.
On a physiological level, we know that ketamine stimulates neurological pathways that make it possible for new thought patterns to emerge. These brain changes are not only helpful for short-term relief, but also make long-term healing possible. For the first time, patients may be able to recognize that their trauma exists separately from them; from this new vantage point, the fear of those memories may not loom quite as large.
At Hudson Mind, our patients experience even greater improvements when treated with both ketamine and Dual Sympathetic Blocks, which temporarily pause the heightened fight-or-flight state of the nervous system. With the nervous system no longer on high alert, PTSD patients are able to comfortably ease into their ketamine experience without amplified fear and anxiety.— Dr. Marcel Green
Dr. Marcel Green is a double board-certified psychiatrist with a degree from Columbia University’s medical school. At Hudson Mind, he specializes in integrating breakthrough interventional psychiatric treatments with traditional psychiatric and psychological treatment models. From these experiences, he’s able to treat PTSD by using ketamine in a customizable approach.
Dr. Tyson Lippe, MD – Heading Health
Ketamine has been shown to be beneficial for PTSD in some studies, especially for those who have not responded to traditional treatments such as oral medications and psychotherapy… through the use of ketamine, patients may gain a new perspective on traumatic events which, in turn, can help them process what occurred. Best outcomes occur when ketamine is combined with traditional treatments, especially psychotherapy, for those experiencing symptoms of PTSD.— Dr. Tyson Lippe, MD
Dr. Tyson Lippe, MD is a licensed psychiatrist in the state of Texas, and sees patients in Heading’s Austin, TX clinic and via telehealth. His clinic accepts most insurance, and helps patients gain access to the right combination of tools to address their individual needs. Also offering consultations for specialized treatment — including Spravato, Ketamine, and Transcranial Magnetic Stimulation (TMS) — Dr. Lippe combines trust with his experience.
Dr. Joseph Swider, DO – Heading Health
Post-traumatic Stress Disorder is complex, and for many patients being treated, it occurs alongside depression. Ketamine is used clinically as a rapid-acting antidepressant. Research is also supporting the use of ketamine for PTSD as it is shown to influence parts of the brain that control fear responses, emotional regulation, and memory processing… PTSD is very much like a severe form of anxiety, and ketamine can help a patient better process fear and stress. At Heading we also encourage therapy in tandem with ketamine treatment which is shown to be a more effective method than medication alone.— Dr. Joseph Swider, DO
Dr. Joseph Swider, DO is a psychiatrist with over 20 years of experience treating challenging mental health issues. He sees patients in Heading’s Austin, Texas clinic and via telehealth, and he accepts most insurance. For those struggling with treatment-resistant depression, Dr. Swider offers consultations for specialized treatment, including Spravato, Ketamine, and Transcranial Magnetic Stimulation (TMS).
Dr. Abid Nazeer, M.D. – Advanced Psychiatric Solutions
Ketamine’s antidepressant properties have commanded a historic change in how we view the treatment of depression; however Ketamine therapy is also revolutionary in the treatment of PTSD. The traditional approach to treatment of PTSD involves trauma focused psychotherapy (e.g., EMDR and Rapid Trauma Therapy), as well as medications such as SSRIs (e.g., Sertraline or Paroxetine). They can take weeks to become effective and have about a 33 percent success rate. Ketamine has roughly a 70 percent successful response rate and can become effective very quickly. Ketamine has a medical benefit of triggering your brain to rebuild neurotransmitter pathways and wake up communication between different regions. This is called ‘neuroplasticity,’ and it can help develop new thought patterns surrounding past traumatic events much more easily. During treatment, ketamine can cause dissociation and changes in perception. Though this may be viewed as an adverse effect in some situations, it can more commonly be quite beneficial. In PTSD, there can be reexperiencing of the traumatic memory with vivid clarity, from a whole new vantage point, and none of the anxiety or negative emotions that are usually associated. The result is that the person has a sudden shift in how they view that memory and feel a sense of mastery or control over it, especially when a therapist is guiding you through the process and utilizing this ketamine effect as a tool to assist the trauma therapy.— Dr. Abid Nazeer, M.D.
Dr. Abid Nazeer, M.D. is the Founder of Advanced Psychiatric Solutions. APS delivers integrated mental health care, the first clinic of its kind in the Midwest offering ketamine therapy. Dr. Nazeer is board certified in Psychiatry, as well as Addiction Medicine. He has a long history of leadership experience — including past Chief Medical Officer positions at Wesana Health and Symetria Recovery.
Dr. Nazeer helped pioneer the comprehensive psychiatry-based ketamine model and development of the current standards of care for safe use of ketamine for mental health conditions.
He has extensive experience in clinic operations, insurance payer negotiations, outcome measurement, and pharmacogenetics. He is recognized as a thought leader at the intersection of psychedelics, ketamine, and psychiatry. Dr. Nazeer speaks nationally, educates peers, and has media appearances on these topics. He is the inaugural Vice-President of the American Association of Psychedelics and early member of ASKP.
Debra Ferguson – Daytryp Health
Daytryp’s dosage for PTSD is similar to that of major depressive disorder (MDD). We start low (.25 -.50 mg/kg of bodyweight) and incrementally increase until we find a dose that the client deems the most comfortable. Doses are unique for each client to achieve the benefits they are seeking from treatment and are determined by the practitioner and client together.
During our initial consult meeting, we discuss logistics and provide our clients with pre and post ketamine therapy recommendations, integration tips, and a small journal to ensure they are as prepared as possible for their journey. For all ketamine sessions, we start by taking blood pressure, heart rate and oxygen saturation. We also provide Zofran, an anti-nausea medication. This ensures the client does not risk experiencing nausea, which could negatively affect their journey. Music is an integral piece for KAP so we provide suggested playlists. However, clients are free to use music of their choosing. Eye masks are also provided.
We open the session with a “prayer” for the client and the ketamine molecule. We may discuss intentions at that time. If a client would like to set up their own altar or bring items that are special to them, to assist with their journey, this is all welcomed. We make this a very sacred experience.
Once in the medicine, we monitor respirations and assess for tolerability. We keep them safe and are available for any assistance, if needed. We are dutifully mindful to be supportive but not interfere with the client’s journey.
Once out of the medicine, we assist clients with using the restroom if needed and provide tea along with small organic bites. Once they are able to verbalize about their journey, we act as a scribe, using their journal. We feel this is important as details from their ketamine experience can be fleeting. We find that during this process, valuable insights are made. If the client finds their experience difficult to describe, we may ask questions but this is not a “therapy” session. After the client feels they’ve sufficiently processed, we close the session, again with a “prayer” to the client and the ketamine molecule, asking that they continue to work together in the client’s healing journey. One final post KAP vitals reading, with the session ending when the client is able to walk and tolerate food and fluids.
Daytryp Health offers weekly group sessions where clients are welcome to discuss their journeys, experiences, and insights, further facilitating the integration process.— Debra Ferguson
Debra Ferguson is a savvy and seasoned psychonaut and contributing member to the Daytryp Health Psychedelic Wellness Center team.
Ajona Olsen, MSN, APRN, ANP-C – Daytrp Health
Ketamine and more specifically Ketamine Assisted Psychotherapy (KAP) effectively allows the individual to witness events of their trauma that potentially caused PTSD without being drowned in the emotions of the memory. Making novel neural pathways is the cardinal feature of ketamine. Once the individual can integrate these traumatic memories, they often notice a shift in their emotional processes, and they begin to heal.— Ajona Olsen, MSN, APRN, ANP-C, Medical Director of Daytryp Health LLC
Ajona Olsen, MSN, APRN, ANP-C began her career in healthcare in 2001 as a registered nurse (RN) in the hospital and in 2006 became a nurse practitioner and continued working in corporate medicine. Her career path changed when she found Ketamine Assisted Psychotherapy (KAP) in 2021 and decided to open her own private practice. Ajona is now collaborating with Daytryp Health – a state of the art Psychedelic Assisted Psychotherapy clinic in Phoenix, AZ.
Jenna Reeder, NP – Jenna Reeder, NP — Integrative Psychiatry
Ketamine’s effectiveness in treating PTSD is not fully understood but research suggests that it is related to specific ketamine-induced changes in the brain. PTSD symptoms can cause loss of synaptic connectivity in various regions of the brain, including the hippocampus, prefrontal cortex, and the amygdala, which may contribute to the complex profile of symptoms associated with PTSD. Ketamine may help treat PTSD by increasing glutamate in the brain which triggers the formation of new neural connections and strengthening of existing ones, therefore reversing trauma-related synaptic abnormalities. Ketamine also increases brain-derived neurotrophic factors (BDNF), a protein that plays a critical role in PTSD treatment and recovery. Elevated BDNF levels in the brain can enhance fear extinction and reduce exaggerated behavioral responses associated with PTSD. When ketamine is combined with psychotherapy to treat PTSD, research has shown prolonged positive treatment effects for patients, as well as lower relapse rates.— Jenna Reeder, NP
Jenna Reeder, NP is a board-certified psychiatric nurse practitioner specializing in integrative psychiatry and ketamine therapy. She received her NP degree from the University of California, San Francisco. She has completed advanced training for ketamine medical providers and ketamine-assisted psychotherapy. She offers traditional psychiatric medication management, psychotherapy, and ketamine therapy at her private practice in Brooklyn, NY.
Dr. Rafael F. Cruz, MD – Kentuckiana Ketamine Institute
Ketamine remains the fastest and most effective treatment for PTSD and Treatment Resistant Depression. The ketamine dosage sometimes needs individual adjustment for PTSD. Also some PTSD sufferers need an extra boost of IV Vitamin Therapy such as Mega C Meyers, Glutathione, and Amino Acids based on the individual’s deficiencies and medical history. Finally, all need to learn new coping skills which we teach at our practice.— Dr. Rafael F. Cruz, MD
Dr. Rafael Cruz, MD is a nationally recognized leader in Integrative Medicine. As a researcher, educator and clinician, Dr. Cruz has the credentials and experience that inspire confidence.
In his private practice, Kentuckiana Integrative Medicine, he provides a spectrum of advanced health solutions with an integrative, holistic focus. He believes in blending the best aspects of conventional / traditional medicine with Natural / Integrative Medicine.
Dr. Radowitz – Nushama
We recognize that unprocessed trauma or difficult life situations are at the root of most mood disorders… Therefore, we treat PTSD with ketamine in a similar manner to how we treat anxiety, addiction, OCD, eating disorders, and various forms of depression. The psychedelic therapy process with ketamine starts with preparation, setting intentions for what they want help processing during their journey—a person with PTSD can choose to reframe their narrative around their trauma. After the treatment experience, through a process of integration with a therapist or coach, people feel safe and supported to work through their trauma without necessarily having to re-experience it. This new perspective can empower them to accept these past events with greater ease, learn and grow from them, let go of unhealthy attachments so that they can transcend and live life with greater ease and peace.— Dr. Radowitz
Dr. Radowitz has a wealth of experience seeing the effects trauma can have on our physical health firsthand. He joined Nushama to oversee and develop treatment modalities, believing psychedelics are the future of mental wellness as current solutions treat symptoms, not underlying issues.
Dr. Christopher Romig – ARK Integrative Medicine
Ketamine works to help alleviate symptoms of PTSD by targeting the brain’s glutamate receptors, which are involved in memory and learning. By modulating these receptors, ketamine can help reduce the intensity and frequency of intrusive thoughts, nightmares, and other PTSD symptoms. Additionally, ketamine’s fast-acting and long-lasting effects make it a promising option for individuals who have not responded well to traditional therapies for PTSD.— Dr. Christopher Romig
Dr. Christopher Romig M.D., is the owner, founder and medical director of Ark Integrative Medicine and Therapeutics. He is a board certified anesthesiologist with 20 years of experience and more than 6 years of experience in the field of ketamine therapy.
Risks of Ketamine Treatment for PTSD
While the research into treating PTSD with ketamine is promising, it’s still a young field. Due to the lack of research, federal guidelines on using it for treatment lags as well. This includes standard dosages.
And while ketamine is broadly safe and carries a relatively low risk of adverse side effects, it does have a small risk of addiction.
Now that you have a better understanding of how to treat PTSD with ketamine, it’s important to speak with your doctor. This will help you discover a reputable ketamine clinic for treatment, helping you understand the risks and benefits.