A study at Columbia found that a single dose of ketamine, given one week before a stressful event, can buffer against a heightened fear response. The research, conducted in mice, suggests that prophylactic administration of ketamine—a drug commonly used as general anesthetic or a rapid-acting antidepressant—might prevent post-traumatic stress disorder (PTSD) symptoms in soldiers and others who subsequently experience psychological trauma. Findings of the study are published online in the journal Neuropsychopharmacology.
[Photo: Dr. Yuval Neria]
Ketamine is a powerful drug, and the researchers are not advocating widespread use for preventing or reducing PTSD symptoms. But if results can translate to humans, giving a single dose of ketamine in a vaccine-like fashion could have great benefit for people who are highly likely to experience significant stressors, such as members of the military or aid workers going into conflict zones, the authors noted.
There are few effective therapies for preventing or treating PTSD, an anxiety disorder that occurs in about one-quarter of individuals who experience psychological trauma. PTSD symptoms include re-living the trauma—experiencing repeated flashbacks, hyperarousal, and hyperreactivity—as well as mood changes, psychological numbing, and chronic physical symptoms such as headache. The likelihood that symptoms will develop depends on the nature and intensity of the trauma and an individual’s response.
Dr. Yuval Neria, Mailman School of Public Health professor of Epidemiology, director of PTSD at New York State Psychiatric Institute at Columbia Medical Center, and a study co-author, said that “while a number of effective therapies aiming to treat PTSD once developed exist, no drug or psychosocial intervention has yet to show sufficient promise in preventing PTSD following exposure to trauma. If the findings will translate to humans, Ketamine may be the first drug that clearly demonstrate prophylactic effects, by improving fear processing among people exposed to extreme stress and trauma, and preventing long term maladaptive behaviors including PTSD.”
Previous studies have shown that giving ketamine before trauma can help reduce stress-related symptoms. However, it was not clear when the drug should be administered relative to a traumatic episode in order to maximize its protective effects.
The research team is currently studying how ketamine works in the brain to influence the response to stress and also hopes to study prophylactic ketamine use ideally among military personnel.
The study was supported by grants from the National Institutes of Health (DP5 OD017908-01 and DP5 OD017908-01), NYSTEM (New York Stem Cell Science), and a NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation.