Authors: Jason Chang, DNP, ARNP-C
Affiliations: AVYIA
Corresponding Author/Contact: jason.chang@avyia.com
Abstract
AJ, a young man plagued for over 11 years by post‑traumatic stress disorder (PTSD), obsessive‑compulsive disorder (OCD), and chronic lumbar radiculopathy with sciatica, achieved rapid and profound relief through an outpatient ketamine microdosing protocol. After experiencing a life‑changing emergency IV ketamine infusion during a pain crisis, AJ enrolled in AVYIA’s microdosing program. Within one week of his first low‑dose oral treatments—combined with supportive CBT and duloxetine—he reported markedly fewer night terrors, eased hypervigilance, significant reduction in nerve pain, and a renewed sense of joy: “It felt like a cloud has been lifted.”
Background
Co‑occurring PTSD, OCD, and neuropathic pain pose major therapeutic challenges. First‑line treatments—SSRIs, SNRIs, antipsychotics, and conventional analgesics—often require weeks to act and may only partially address overlapping symptom domains. Mounting evidence suggests that low‑dose ketamine, long used in anesthesia, can trigger rapid synaptic plasticity and dual‑action benefits in mood and pain pathways.
Introducing the Research
This case study by Jason Chang, DNP, ARNP‑C at AVYIA explores AJ’s transition from an acute IV ketamine rescue to a structured outpatient microdosing regimen. It adds to the growing clinical literature on ketamine’s promise for treatment‑resistant psychiatric disorders and chronic neuropathic pain.
What You’ll Learn
How a personalized ketamine microdosing schedule can rapidly attenuate PTSD and OCD symptoms.
Ketamine’s dual‑use potential to alleviate chronic sciatica via neuroplastic mechanisms.
Best practices for integrating microdosing with psychotherapy and adjunctive pharmacotherapy.
Breaking Down the Research Article
A. The Big Question
Can a structured outpatient ketamine microdosing protocol deliver sustained relief in a patient with long‑standing PTSD, OCD, and chronic nerve pain?
B. How They Did It (Study Design & Methods – Simplified)
Patient Profile: Young adult male with 11‑year history of PTSD (combat‑related), OCD, and lumbar radiculopathy with sciatica.
Triggering Event: Emergency department visit for intractable sciatica; received a single IV ketamine infusion and noted immediate mood lift and pain reduction.
Transition to Microdosing: Enrolled in AVYIA’s outpatient program one week later.
Protocol Details:
Oral ketamine microdose starting at 10 mg every other evening, titrated per response.
Concurrent therapies: Twice‑weekly CBT sessions; daily duloxetine for baseline mood and neuropathic pain support.
Monitoring: Weekly telehealth check‑ins to adjust dose and track symptom scales.
C. Key Findings (The Takeaway)
Within seven days of microdosing initiation, AJ experienced:
↓ PTSD Symptoms: Night terrors nearly ceased; daytime anxiety and hypervigilance greatly reduced.
↓ OCD Rituals: Intrusive thoughts diminished, allowing more efficient task completion.
↓ Chronic Pain: Sciatica intensity dropped by over 50% on patient‑reported scales.
↑ Mood & Function: Described feeling “like rediscovering joy again” and more engaged in life and therapy.
“It’s as if a cloud has been lifted—my mind and body finally feel free.”
D. What Does This Mean For You? (Implications & Significance)
For Patients: Ketamine microdosing may be a rapid, outpatient‑friendly option when conventional treatments underperform.
For Providers: Structured microdosing protocols, combined with CBT and judicious SNRI use, can target both psychiatric and neuropathic pain.
For Pain Management: Offers a non‑opioid strategy to reduce chronic sciatica, leveraging ketamine’s NMDA‑antagonist and downstream synaptogenic actions.
E. Important Considerations & Limitations
Single Case: Findings need validation in larger, controlled cohorts.
Safety & Oversight: Even low‑dose ketamine requires medical supervision to monitor for dissociation or hemodynamic effects.
Individual Variability: Responses to microdosing may differ; personalization is critical.
Conclusion: Embracing a Dual‑Action Treatment Frontier
Recap
AJ’s dramatic improvements in PTSD, OCD, and chronic sciatica underscore ketamine microdosing’s potential as a fast‑acting, dual‑benefit intervention when other therapies fail over years.
Future Directions
Prospective trials should refine optimal dosing schedules, explore long‑term maintenance strategies, and quantify neuroplastic changes via biomarkers.
Call to Action
If chronic PTSD, OCD, or neuropathic pain have resisted standard approaches, discuss individualized ketamine protocols with a qualified provider—new avenues of relief may await.
