Ketamine Therapy for PTSD

What the Evidence Says About Ketamine for PTSD

PTSD is where honest sourcing matters most, because guidance is genuinely mixed. The VA National Center for PTSD's clinician guide, reflecting the 2023 VA/DoD clinical practice guideline, "recommends against the use of the anesthetic ketamine" for PTSD, stating that "clinical trials of ketamine for the treatment of PTSD have not demonstrated a clear benefit" relative to its risks and side-effect burden.

The same VA guidance adds an important nuance: it does not address esketamine (Spravato) for PTSD, and notes esketamine "may be indicated for the treatment of comorbid medication-resistant major depressive disorder" — relevant because depression is highly comorbid with PTSD. In practice, clinics listing PTSD are often treating the depressive symptoms that accompany it. If a clinic proposes ketamine for PTSD itself, it is reasonable to ask what evidence they rely on.

FDA status: No form of ketamine is FDA-approved for PTSD, and VA guidance currently recommends against anesthetic ketamine for PTSD itself. Generic (racemic) ketamine is FDA-approved as an anesthetic; its use for this condition is off-label, prescribed at a clinician's discretion.

Sources:

• VA National Center for PTSD — Clinician's Guide to Medications for PTSD

Related Reading

• Am I a Candidate for Ketamine Therapy?
• Ketamine Side Effects: Is Ketamine Therapy Safe?