Date of Award
2023
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
Objective: The objective of this selective EBM review is to determine whether or not intravenous ketamine is efficacious for symptom reduction in adults diagnosed with chronic posttraumatic stress disorder.
Study Design: A systematic review of two randomized controlled trials (RCT) and one case series published between 2014 and 2021.
Data Sources: All three studies were discovered using PubMed. The articles were published in English, in peer-reviewed journals, and selected based on their relevance to the clinical question, inclusion of patient-oriented outcomes, and recency.
Outcome Measured: The outcome of reduction in posttraumatic stress disorder (PTSD) symptom severity was measured in each study using either the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), PTSD Checklist for DSM-5 (PCL-5), or Impact of Event Scale-Revised (IES-R) scores. The mean change from baseline was calculated to demonstrate the treatment effect.
Results: In the crossover RCT led by Feder A, Parides MK et al., intravenous (IV) ketamine resulted in PTSD symptom reduction measured by a mean total IES-R score 12.70 points lower than the midazolam control group (p = 0.02). In the RCT conducted by Feder A, Costi S et al., IV ketamine administration demonstrated a mean total CAPS-5 score 11.88 points lower than the midazolam control group (p = 0.004). Lastly, in the case series led by Albott CS et al. a 33.27-point mean change from baseline PCL-5 scores (p <0.0005) and an 80% remission rate were recorded after administration of intravenous ketamine.
Conclusion: All three studies in this review demonstrated that intravenous ketamine led to significantly reduced PTSD symptom severity as measured by IES-R, CAPS-5, and PCL-5 scores. This suggests that IV ketamine is an effective method of treatment for chronic PTSD. Further studies should expand the number of participants in the sample populations and explore treatment dosages and duration as well as maintenance therapy regimens.
Recommended Citation
McKenna, Cassandra H., "Is Intravenous Ketamine Efficacious for Symptom Reduction in Adults Diagnosed With Chronic Posttraumatic Stress Disorder?" (2023). PCOM Physician Assistant Studies Student Scholarship. 670.
https://digitalcommons.pcom.edu/pa_systematic_reviews/670