A retrospective analysis of ketamine intravenous therapy for PTSD in real-world care settings
(presented at ACNP)

Background and Significance
Ketamine Intravenous Therapy (KIT) shows promise as a rapid-acting treatment for PTSD, yet data on its real-world effectiveness remain limited. By leveraging a large EHR database from Osmind, this study aimed to better understand symptom changes in patients receiving KIT for PTSD, of whom the vast majority also had comorbid Major Depressive Disorder (MDD).

‍Study Population
From a total of 8,142 individuals with PTSD, 1,306 had complete baseline and post-treatment PCL-5 data.

‍Intervention
Patients received intravenous ketamine infusions at an average dose that stabilized around 1.0 mg/kg by the sixth infusion. PCL-5 scores were assessed before treatment and at multiple points following successive KIT infusions.
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‍On average, patients’ PCL-5 scores declined by 18.6 points (from ~47 at baseline to ~28 after four infusions). Defined as ≥30% decrease from baseline PCL-5, response rates rose from 27% after the first infusion to 70% by the sixth infusion.Treatment Completion: Most patients (82%) completed at least four infusions within 28 days, suggesting a generally acceptable treatment course and pace of infusion.

‍Discussion
These results support KIT’s potential for rapidly reducing PTSD symptoms, especially in patients with comorbid MDD. The observed progressive increase in response rates through repeated infusions reinforces the importance of completing a full treatment course.

Future research should explore the optimal dosing and infusion schedules, along with potential impacts on diverse PTSD subpopulations.

‍Limitations
‍The majority (94%) of participants were Caucasian, limiting generalizability to other racial/ethnic groups.Only 16.5% of the total sample had complete outcome data. Comorbid MDD was highly prevalent (90%), making it challenging to disentangle the effects of PTSD versus MDD. Overall, this retrospective analysis provides real-world evidence that KIT may offer meaningful symptom relief for individuals with PTSD, though further research in more diverse samples is warranted.