When PTSD Has Not Improved With Standard Care
Post-traumatic stress disorder affects an estimated 3.6% of U.S. adults in a given year (National Institute of Mental Health, n.d.). For people on Maryland’s Eastern Shore and across the Delmarva Peninsula, access to specialized trauma-focused care can be complicated by geography, transportation, work schedules, and other barriers.
Evidence-based trauma-focused psychotherapies remain the recommended primary treatment for PTSD. At KetaMed Infusion Center in Salisbury, our team evaluates patients with treatment-resistant PTSD for IV or IM ketamine therapy as an individualized, off-label option—not as a replacement for trauma-focused care.
What Research Does and Does Not Show
PTSD can involve persistent intrusion, avoidance, negative changes in mood and thinking, and heightened arousal. Ketamine is an NMDA receptor antagonist that has been studied as a possible treatment for PTSD because of its effects on the glutamate system.
Some controlled trials of IV ketamine have reported rapid reductions in PTSD symptom severity. A randomized trial of repeated IV infusions in adults with chronic PTSD found improvement in symptom severity, but further research is needed to understand durability, optimal protocols, and which patients may benefit most (Feder et al., 2021).
The broader evidence base remains limited. A 2024 systematic review and meta-analysis found modest early reductions in PTSD and depression scores, while noting that the duration of benefit remains uncertain (Sicignano et al., 2024). The 2023 VA/DoD Clinical Practice Guideline suggests against ketamine for PTSD because the quality of available evidence is very low.
How KetaMed Evaluates PTSD
At KetaMed, the consultation begins with a conversation about your history, symptoms, treatment background, current medications, and goals. Our clinical team, including Michelle Ridgeway, a board-certified Psychiatric Mental Health Nurse Practitioner, and Dr. Mirza Umair Baig, a board-certified Emergency Medicine physician, considers the full clinical picture before making a recommendation.
For PTSD patients, the evaluation may include discussion of:
- The nature and timeline of trauma-related symptoms
- Current symptom patterns, including intrusion, avoidance, mood changes, and hyperarousal
- Previous therapy and medication history
- Co-occurring depression, anxiety, substance-use concerns, or other factors that may affect care
- Relevant medical history and current medications
KetaMed offers IV ketamine therapy and IM ketamine therapy for PTSD. The recommended approach depends on the patient’s history, clinical needs, and treatment goals.
Preparing for the Treatment Experience
A common concern for PTSD patients is whether the altered state associated with ketamine could feel distressing or overwhelming. This concern is understandable and should be discussed before treatment begins.
KetaMed talks with patients about what the session may feel like, how treatment is monitored, and what to do if concerns arise. Reviewing our FAQs about ketamine therapy can also help patients understand what to expect before deciding whether to move forward.
Individual experiences vary, and no delivery method or protocol is right for every patient.
Ketamine and Ongoing PTSD Care
Ketamine therapy should not be presented as a replacement for trauma-focused psychotherapy. The current VA/DoD guideline recommends individual trauma-focused approaches, including Prolonged Exposure, Cognitive Processing Therapy, and EMDR, as primary PTSD treatments (VA/DoD, 2023).
For patients already engaged in therapy, the consultation can include discussion of how ketamine treatment may fit alongside their existing care. Patients should not stop therapy or change prescribed medications without guidance from the treating clinician.
For Eastern Shore patients who have been managing PTSD for years without access to a specialized evaluation, KetaMed offers a local, individualized conversation about available options. To get a broader sense of the conditions our clinic addresses, visit our Conditions We Treat page.
Frequently Asked Questions
Which ketamine delivery method is best for PTSD: IV or IM?
KetaMed offers both IV and IM ketamine for PTSD. The recommended format depends on your clinical history, medical considerations, treatment goals, and provider assessment.
Should I continue PTSD medications during ketamine treatment?
Do not stop or change psychiatric medications without guidance from the prescribing clinician. A medication review is part of the consultation process.
Is ketamine effective for military veterans with PTSD?
PTSD research on ketamine has included veteran and active-duty populations, but the overall evidence remains limited and does not establish that ketamine will be effective for every individual. A consultation can help determine whether an evaluation is appropriate for your situation (Sicignano et al., 2024; VA/DoD, 2023).
What if I am currently in PTSD therapy?
Do not pause or change an effective therapy plan without discussing it with your therapist or prescribing clinician. Trauma-focused psychotherapy remains a recommended primary treatment for PTSD.
How many sessions are typically needed for PTSD?
There is no single treatment schedule that is appropriate for every patient. Timing, number of sessions, and follow-up planning depend on the individual clinical evaluation and response over time.
Key Takeaways
- PTSD affects an estimated 3.6% of U.S. adults in a given year (National Institute of Mental Health, n.d.).
- KetaMed evaluates PTSD patients individually, considering symptom history, prior treatment, medications, medical factors, and treatment goals.
- IV ketamine has been studied in PTSD clinical trials, but the evidence base remains limited and the durability of benefit is uncertain.
- The 2023 VA/DoD guideline suggests against ketamine for PTSD because of very-low-quality evidence.
- Trauma-focused psychotherapy remains a recommended primary treatment for PTSD.
- Ketamine is used off-label for PTSD, and results vary by individual.
Conclusion
PTSD is a complex condition that deserves thoughtful, evidence-informed care. At KetaMed Infusion Center in Salisbury, our team provides an individualized evaluation for Eastern Shore and Delmarva patients who want to discuss whether IV or IM ketamine therapy may fit within their broader treatment plan.
Contact our team to schedule a consultation and learn more about your options.
References
Feder, A., Costi, S., Rutter, S. B., Collins, A. B., Govindarajulu, U., Jha, M. K., Horn, S. R., Kautz, M., Corniquel, M., Collins, K. A., Bevilacqua, L., Glasgow, A. M., Brallier, J., Pietrzak, R. H., Murrough, J. W., & Charney, D. S. (2021). A randomized controlled trial of repeated ketamine administration for chronic posttraumatic stress disorder. American Journal of Psychiatry, 178(2), 193–202. https://doi.org/10.1176/appi.ajp.2020.20050596
National Institute of Mental Health. (n.d.). Post-traumatic stress disorder. https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd
Sicignano, D. J., Kurschner, R., Weisman, N., Sedensky, A., Hernandez, A. V., & White, C. M. (2024). The impact of ketamine for treatment of post-traumatic stress disorder: A systematic review with meta-analyses. Annals of Pharmacotherapy, 58(7), 669–677. doi:10.1177/10600280231199666
U.S. Department of Veterans Affairs & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for management of posttraumatic stress disorder and acute stress disorder. https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Full-CPG-Edited-111624-V5-81825.pdf
About Our Team
At KetaMed Infusion Center in Salisbury, MD, our clinical team—including Michelle Ridgeway, a board-certified Psychiatric Mental Health Nurse Practitioner, and Dr. Mirza Umair Baig, a board-certified Emergency Medicine physician—approaches each evaluation as a complete clinical picture rather than a single presenting complaint.
We offer IV ketamine, IM ketamine, and ketamine troches for patients with bipolar disorder, treatment-resistant depression, anxiety, PTSD, and complex mood presentations across the Delmarva Peninsula. Our team takes the time to understand each patient’s full mood and treatment history before making any recommendation.
Medical Disclaimer
The content in this blog post is intended for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Ketamine is used off-label for PTSD. Results vary by individual. Always discuss treatment options, risks, and benefits with a qualified healthcare provider before making medical decisions.
If you are in immediate crisis or having thoughts of harming yourself, call or text 988 or go to the nearest emergency room.