Ketamine Infusion Therapy for PTSD in Combat Veterans

The prolonged conflicts in Iraq and Afghanistan have created a very large population of
veterans who suffer from severe post traumatic stress disorder (PTSD). This has, in part,
contributed to a rate of suicide that many clinicians and concerned citizens find alarming.
In the last two decades, there has been some promising evidence coming to light showing that
the medication ketamine can potentially suppress and/or alleviate some of the disturbing
symptoms of PTSD such as hypervigilance, anxiety, anger, and recurrent nightmares. If
ketamine could be shown to be be a valuable treatment option for PTSD then this could have
potentially large positive ramifications for the treatment of PTSD in America's veteran
population.

Ketamine has historically been used as a dissociative anesthetic in emergency departments,
operating rooms, and in austere military environments. It is a proven medication with a
reassuring safety profile. This current study seeks to add to the body of knowledge regarding
ketamine therapy by specifically looking at the combat veteran population. Eligible veterans
will undergo the standard six-infusion Induction Series of ketamine infusions at Klarisana in
San Antonio, Texas. Klarisana is a healthcare center which offers outpatient ketamine
infusion therapy for the treatment of severe depression, PTSD, and various chronic pain
conditions such as rheumatoid arthritis, fibromyalgia, neuropathy, and migraine headaches.
Klarisana serves patients from all over south Texas including Austin, Houston, San Antonio,
and Corpus Christi.

Patients who enroll in the current PTSD study will receive a standard battery of survey
instruments which Klarisana implements before and after a series of infusions. These
instruments will assess each patient's level of depression, degree of PTSD symptoms, as well
as their use of alcohol and recreational drugs. The specific instruments are the...

Patient Health Questionnaire (PHQ-9) PTSD Checklist (PCL-5) Drug Abuse Screening Test
(DAST-10) Alcohol Use Disorders Identification Test (AUDIT)

The investigator's goal is to formally analyze what changes may occur the participants'
symptoms of PTSD and try to better establish the role which ketamine infusion therapy may
play in the treatment of PTSD in the combat veteran population.

Inclusion Criteria:

- The Veteran must be medically screened by Klarisana and be an appropriate candidate
for ketamine therapy

- The Veteran must be between the ages of 18 and 75. The study is open to men and women.

- The Veteran must be able to speak and read the English language

- The Veteran must have a diagnosis of post-traumatic stress disorder assigned by the
Department of Veterans Affairs. Veterans of a foreign military are also eligible but
they must have been diagnosed with PTSD by the equivalent veteran healthcare
organization in their country of military service

- The Veteran must have served in the US Military or a foreign military service in a
designated combat zone. Documentation by a DD214 or equivalent is required

- The PTSD that The Veteran is suffering from has to have been caused by service in
combat

- The PTSD that the Veteran is suffering from must be exerting a significant negative
effect on his/her life

Exclusion Criteria:

- The Veteran must NOT be taking lamotrigine (Lamictal) or any monoamine oxidase
inhibitor antidepressants

- The Veteran must not be currently enrolled in any other studies offering therapy for
PTSD

- Veteran may NOT have uncontrolled blood pressure or congestive heart failure

- Veteran may NOT have a diagnosis of psychosis or any diagnosis on the psychosis
spectrum