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Ketamine for PTSD

Ketamine is gaining popularity in the psych-mental health world when used to treat PTSD and other mental health illnesses.  This is because of ketamine’s ability to rapidly relieve patient’s symptoms and do it safely.  These claims are backed by a robust body of medical studies.  If standard mental health therapies have failed or provided poor relief, ketamine can be used alone or in conjunction with a patient’s existing regime.  

Recognizing and diagnosing PTSD is often a difficult first step.  Treatment however, just got a lot more hopeful since the discovery of ketamine’s uses for mental health disorders. 

Ketamine for PTSD
Ketamine for PTSD

Ketamine Could Be The Life-Changing and Game-Changing Weapon to Fight PTSD.

Scientific studies, including randomized-controlled trials, suggests that ketamine is a safe and powerful medication to rapidly improve the symptoms of PTSD, as well as significantly reduce suicidal thoughts.  The drug rapidly reduces symptoms of PTSD by changing neural and synaptic pathways, promoting antidepressant effects and lowering hyperarousal symptoms commonly seen in PTSD.  Oftentimes, a significant improvement is seen within the first or second treatment.  Furthermore, patients completing a ketamine treatment program have reported to achieve complete disease remission from acute or chronic mental health disorders.  

AVYIA can help start the healing process on day one with science-backed, evidenced-based ketamine treatments that may forever change your life, and your loved ones.

Key Statistics and Realities About PTSD

Prevalence

Prevalence

According to the National Center for PTSD, about half of all individuals who experience trauma will develop PTSD, which equates to 6.1-9.2% of the US population. Of the 1.9 million veterans, approximately 209,000-380,000 will develop PTSD according to the VA. 1/3 will have lifelong symptoms.

Age of onset

Age of onset

It may vary depending on the type of trauma and other environmental factors. For example, studies have found that PTSD related to childhood abuse or neglect is more likely to develop in early adulthood, while PTSD related to military combat is more likely to develop in middle age.

Gender differences

About 10% of women in the United States will develop PTSD at some point in their lives (sexual assault and domestic violence), compared to about 4% of men.

Comorbidity

Most common comorbidities associated with PTSD include: depression, anxiety disorder, eating disorders, and sleep disorders, excessive alcohol and drugs.

Disability

Disability

PTSD can have a significant impact on a person's daily life, including their ability to work, maintain relationships, and participate in activities they once enjoyed.

Access to treatment

Unfortunately, many individuals with PTSD are not seeking treatment mainly due to stigma concerns, cost issues, lack of trained providers and fear by talking about PTSD will trigger their symptoms.

What is PTSD?

Post-traumatic stress disorder, or PSTD, is a complicated and debilitating mental health disorder that stems from experiencing a traumatic event.  PTSD is associated with a cluster of different affective, cognitive, and behavioral symptoms, oftentimes coinciding with other mental health disorders such as anxiety and depression. 6.1% to 9.2% of Americans will have PTSD sometime in their lifetime.  Of the 1.9 million veterans in the US, approximately 209,000 to 380,000 will develop PTSD according to the Department of Veteran Affairs. Veterans and soldiers are not the only individuals who suffer from PTSD. Any individual who has experienced severe emotional or physical trauma, may develop PTSD.  It is estimated that approximately 1/3 of PTSD patients persist to have lifelong symptoms, failing to achieve remission.  AVYIA’s ketamine program aims to change that trend.  

PTSD is caused by traumatic events involving death, serious injury, or sexual violence.  It can lead to the development of many other health issues, such as suicide.  Many whom suffer from PTSD do not seek help in a timely manner, or often go undiagnosed for long periods of time.

Although PTSD is commonly associated with military service men and women in combat, any traumatic event or series of events can lead to the development of PTSD.  This is especially true if traumatic events feel unpredictable and uncontrollable.  In fact, women have higher rates PTSD development due to a higher incidence of trauma associated with sexual assault, domestic violence, childhood abuse and gender-based violence. 

While individuals in direct contact with horrific events may develop PTSD, those that witness traumatic events are at risk as well.  Individuals that engaged in the aftermath of horrific events, such as emergency responders and law enforcement officers, are prime examples of at-risk individuals.  PTSD not only affects the patient suffering from the illness, love-ones of the patient also tend to be affected in immeasurable ways.    

Albott, C. S., Lim, K. O., Forbes, M. K., Erbes, C., Tye, S. J., Grabowski, J. G., Thuras, P., Batres-y-Carr, T.M., Wels, J., & Shiroma, P. R. (2018). Efficacy, safety, and durability of repeated ketamine infusions for comorbid posttraumatic stress disorder and treatment-resistant depression. The Journal of Clinical Psychiatry, 79(3).

What are the Symptoms of PTSD?

Keep in mind that symptoms don’t always equate to a diagnosis.  Medical and mental health professionals should always be consulted in order to make a diagnosis.  Now, let’s take a look at some of the most common symptoms associated with PTSD:

Intrusive Symptoms

Intrusive Symptoms

• Intrusive thoughts or memories of the traumatic event(s)
• Distressing and vivid nightmares related to the trauma
• Flashbacks or dissociative episodes, where it feels as if the traumatic event is happening again
• Intense psychological distress or physiological reactions when exposed to reminders of the trauma
• Thoughts about committing suicide
Avoidance Symptoms

Avoidance Symptoms

• Avoiding activities, places, or people that remind the individual of the traumatic event(s)
• Efforts to avoid distressing thoughts, feelings, or conversations associated with the trauma
• Amnesia or difficulty recalling important aspects of the traumatic event(s)
• Decreased interest in previously enjoyed activities or detachment from others
• Difficulty maintaining healthy relationships, experiencing joy, love and affection
Avoidance Symptoms

Negative Changes in Cognition and Mood

• Exaggerated negative beliefs or expectations about oneself, others, or the world
• Persistent negative emotional states, such as fear, anger, guilt, shame, or sadness
• Feelings of detachment from others, social withdrawal, or emotional numbness
• Diminished interest in activities or a sense of a foreshortened future
• Depression, feeling “the blues” or “down”
Alterations in Arousal and Reactivity

Alterations in Arousal and Reactivity

•Irritability, anger outbursts, or aggressive behavior
•Recklessness, dangerous or self-destructive behavior
•Hypervigilance, feeling constantly on edge, or being easily startled
•Problems with concentration or focus with day-to-day activities
•Sleep disturbances, including insomnia or nightmares
•Anxiety and panic attacks

What Types of Trauma Causes PTSD?
What Are The Risk Factors of PTSD?

Any individual is able to develop PTSD if the correct threshold of trauma is sustained.  Some individuals are more susceptible, others are more resilient.  It’s important to note that suffering from a traumatic event does not always lead to PTSD, but it does put an individual at risk of developing PTSD.  Diagnosis of PTSD should be always be performed by a qualified medical or mental health provider.  Below are some potential causes and risks factors of PTSD.

Sexual assault – Experiencing sexual assault can be an extremely traumatic event, leading to profound feelings of fear, helplessness, vulnerability, anger, and a smattering of other indescribable feelings.  Victims often go undiagnosed and untreated unfortunately.   

Intense and life-threatening events Most common among military personnel, first responders, and law enforcement.  Examples of threatening events include combat, war, terrorist attacks, or accidents resulting in fatalities.

Sustaining an injury, both traumatic and medically – Surviving a major car accident, heart attack, stroke, or a chronic illness can be traumatic in itself. The sudden and unexpected nature of these events can cause feelings of fear, anxiety, and uncertainty, which may contribute to the development of the disorder.

Exposure to violence – Individuals who have been victims of violent acts, such as kidnapping or burglary.  Those who have experienced life as refugees in war-torn regions often endured life-threatening situations.

Interpersonal traumatic experience – The loss of a loved one, especially due to a severe illness, can be deeply traumatic. Grief, helplessness, and guilt, may spiral out of control, putting the individual at risk of PTSD.

Surviving a natural disaster – Natural disasters like earthquakes, hurricanes, floods, or wildfires can cause extensive damage, loss of life, and displacement. Survivors of such disasters may develop PTSD due to the trauma they endured during the event and its aftermath.

Childhood trauma or abuse – Traumatic experiences during childhood, such as physical, emotional or sexual abuse, are common causes.  Other causes include neglect and growing up in a dysfunctional environment.

* Microdosing costs $150 per month for most patients. For patients who require higher dosages, the cost may increase due to the higher cost of the medication. Microdosing patients are required to have an at-home visit before commencing the medication.

Healing from Trauma and PTSD. Ketamine Can Help.

Ketamine has a well-established safety record, has been widely utilized as both an anesthetic and pain reliever for an extended period of time. Since its approval by the FDA in 1970, ketamine has emerged as a preferred tool for combat medics in the field due to its rapid-acting anesthetic and analgesic effects.  Additionally, ketamine’s ability to elevate a soldier’s heart rate and blood pressure proves valuable in addressing blood loss. A soldier in a state of “K-hole” induced by ketamine becomes more manageable to load and transfer away from potential danger. 

Recently, medical professionals have started utilizing ketamine to treat chronic pain and mental health disorders, such as depression and anxiety.  By blocking pain receptors in the brain and calming the HPA axis, ketamine can provide relief. It may also promote the formation of new and healthy synapses (connections between nerves) in the brain.  In fact, there is an ever growing body of scientific research that supports the use of ketamine to treat PTSD, as well as the co-morbid conditions associated with it, such as anxiety and depression.  

While high doses of ketamine can cause sleepiness and induce sedation when used in anesthesia, for the treatment of PTSD, low doses are administered to avoid adverse effects such as excessive drowsiness.  At AVYIA, we offer three treatment options for treating PTSD. Selection of a treatment program is typically based on the patient’s preference, but AVYIA’s providers will also consider each patient’s safety profile, medical history, medical conditions, and timeframe of therapeutic goals.  Collaborative decision-making between the healthcare provider and the patient is essential to ensure the most effective and well-tolerated treatment plan.

How Does Ketamine Treat PTSD?

The trauma that causes PTSD is thought to result in issues with the neural circuitry within the amygdala, prefrontal cortex, and hippocampus of the brain.  As a result, brain chemistry and brain functions are negatively affected, which then manifests as symptoms of PTSD.  Ketamine works on the NMDA receptors of the brain to help re-balance the neurotransmitter glutamate.  

Ketamine is hypothesized to promote neuroplasticity, or the ability of the brain’s neural-networks to be flexible, changing and reorganizing.  Neuroplasticity is thought to fight disease states by resetting the brain’s neural-networks, as well as restructuring the brain structures back to its normal state.  Many experts believe the psychedelic and dissociative properties of ketamine are catalysts of neuroplasticity.  What we do know is that ketamine also helps release BDNF (brain-derived neurotrophic factor), which aids in neuroplasticity initiation.  In the context of PTSD, neuroplasticity may help the brain adapt and recover from traumatic experiences, potentially leading to reduced symptoms over time.  

PTSD is often manifested by symptoms of hyperarousal, where individuals experience heightened anxiety, hypervigilance, and an exaggerated startle response. Ketamine’s calming effects on the central nervous system may be able to help alleviate these symptoms and induce a sense of relaxation.

Ketamine may facilitate emotional processing, allowing individuals to explore and process traumatic memories and emotions in a more controlled and less distressing manner. This can be especially beneficial in therapy sessions where ketamine-assisted psychotherapy from a therapist or counselor can be implemented.  

Healing from trauma, ketamine can help

Norbury, A., Rutter, S. B., Collins, A. B., Costi, S., Jha, M. K., Horn, S. R., Kautz, M., Corniquel, M., Collins, K. A., Glasgow, A. M., Brallier, J., Shin, L. M., Charney, D. S., Murrough, J. W., & Feder, A. (2021). Neuroimaging correlates and predictors of response to repeated-dose intravenous ketamine in PTSD:  Preliminary evidence. Neuropsychopharmacology. https://doi.org/10.1038/s41386-021-01104-4

ketamine vs antidepressant

Conventional Therapies vs Ketamine Treatment

Conventional therapies for PTSD, such as SSRI’s, benzodiazepines, mood stabilizers, and anti-psychotics, may have serious unwanted side effects, and oftentimes can also make individuals feel worse.  Conventional medications may sometimes take weeks to months to optimize.  PTSD patients have a poor success rates of achieving complete remission, and 1/3 of all PTSD patients have chronic, life-long symptoms.  

Ketamine’s safety has a decades-long track record in the medical setting.  Studies have shown that ketamine for the treatment of PTSD starts providing immediate relief of symptoms and suicidal thoughts, oftentimes starting within the first treatment session.  AVYIA’s recommended 6 sessions of IV therapy or 8 sessions of intranasal therapy for PTSD.  AVYIA also offers microdosing oral tablets for daily dosing treatment, which allows the patient to self-administer and manage symptoms on their own schedule.  

Liriano, F., Hatten, C., & Schwartz, T. L. (2019). Ketamine as treatment for post-traumatic stress disorder: A Review. Drugs in Context, 8, 1–7. 

FAQ

Since the FDA has not yet authorized ketamine for the treatment of PTSD, doing so is regarded as “off-label” usage and is not widely supported by insurance. However, the encouraging outcomes of studies on ketamine’s potential to treat PTSD have gain acceptance from some insurance companies. Please refer to our insurance page and talk to your insurance company.

Avyia’s daily microdosing program is an affordable option if your insurance does not cover ketamine therapy.  The program costs $150/month for the majority of patients that use standard doses.  You’ll receive regular follow-ups from your provider , and you can cancel anytime.  The first month requires an additional $150 for a doctor’s initial evaluation and assessment.  

Experiences are different from patient to patient, and session to session.   

Psychedelic experiences and dissociative effects may occur in the doses we give for IV and intranasal treatments.  This is also known an out-of-body experience, or going on “a trip.”  Feelings of euphoria, drowsiness and an odd or surreal sense are also typical symptoms.  After completion of a treatment, some patients have reported false epiphanies, such as “knowing the meaning of life.” 

All these effects are typically short lasting once the treatment is over.  Patient’s are back to their baseline the next day typically, but we still recommend exercising caution.  Patients should not drive while under the influence of ketamine, nor should they make rash decisions on false epiphanies.  Finally, AVYIA requests patients have a responsible adult present to monitor patients after the healthcare providers finish their monitoring efforts.  

Ketamine may also bring about emotional catharsis, allowing individuals to process and release pent-up emotions. Post session, some individuals may experience introspection and gain insights into their thoughts and emotions. 

Ketamine shows potential as a treatment option for different types of mental health concerns. Besides PTSD, it may offer relief to people struggling with depression, anxiety, addictions, as well as obsessive-compulsive disorder (OCD), based on studies conducted so far.

Ketamine has an immediate response rate, which is one of its key advantages over other mental health therapy modalities like antidepressants and SSRIs. Ketamine frequently provides relief within minutes to hours if given in IV form, while other pharmaceuticals may take weeks or even months to show substantial results.

Ketamine is typically not included in the most commonly used drug tests. However, if you are tested specifically for ketamine, it will definitely be positive. Ketamine therapy is not meant for recreational use and patients should advise family members for support. 

Ketamine can be injected either into a vein (IV) or into a muscle if a vein is not accessible.  For therapeutic purposes, slowly administered IV infusion has proven to be effective due to its bioavailability and time to onset.  Alternatively, ketamine can be administered through nasal spray or through oral tablets (microdosing).  The advantages for nasal and oral administrations are the non-invasive nature of the treatment and ease of administration.

Patients with a history of schizophrenia, schizo-affective disorder should not receive ketamine therapy.  Recent psychosis or psychotic episodes are also contraindicated.

Patients who have uncontrolled high blood pressures may need to address their hypertension before starting ketamine infusion therapy.

AVYIA requires a pre-treatment appointment from every patient to thoroughly review the medical history for eligibility, safety, and treatment planning. 

For more frequently asked questions, please visit our FAQ page.