Synopsis: Wondering if ketamine therapy could actually make PTSD symptoms worse? This blog explores the research-backed benefits of ketamine for PTSD, the potential risks of unprepared treatment, and how to ensure safe, effective care. Plus, we introduce an alternative option (stellate ganglion blocks) for those seeking a non-psychedelic approach to healing.
This blog is based on the transcript of our Can KetamineTreatments Make PTSD Worse? video
Can Ketamine Therapy Worsen PTSD? Here’s the Truth
You might be wondering, can ketamine therapy actually make PTSD worse? If so, that is a valid concern and one that deserves a thoughtful, evidence-based answer. While ketamine has shown promise in treating PTSD, it's not without its risks.
In this blog, we’ll break down what the latest research says about ketamine therapy for PTSD, including key study findings and the types of experiences patients may have.
You’ll also learn how preparation, integration, and clinical oversight play a critical role in reducing risk. And for those seeking a non-psychedelic option, we’ll introduce an alternative treatment called the stellate ganglion block (SGB).
Ketamine’s Role in PTSD Treatment
Let’s start with ketamine’s potential in treating PTSD. There’s a growing body of research suggesting that ketamine therapy may provide meaningful relief for individuals with chronic post-traumatic stress disorder.
One key study by Dr. Adriana Feder and colleagues, published in the American Journal of Psychiatry in January 2021, explored the use of IV ketamine in patients who had been living with PTSD for an average of 15 years. Many of these participants had previously tried multiple medications in particular antidepressants with little to no success.
In the study, 30 individuals were randomly assigned to receive either IV ketamine or IV midazolam, a medication used as an active placebo to mimic some psychoactive effects without directly treating PTSD. Participants received six infusions over a two-week period.
The results? Patients who received ketamine saw an average 50% reduction in PTSD symptoms. Even more promising, individuals with comorbid depression experienced improvements in both their PTSD and depressive symptoms. No serious adverse effects were reported among those in the ketamine group.
This study was significant not only for its results but also for its design. It was the first randomized, double-blinded trial to assess a full series of IV ketamine treatments (rather than a single infusion) compared to an active placebo for PTSD. This six-infusion protocol mirrors what is commonly used in clinical ketamine practices today.
The takeaway: Repeated IV ketamine infusions over two weeks may offer a fast and effective treatment for PTSD, particularly for those who haven’t responded to traditional medications.
Take a deep dive into ketamine therapy as a treatment for PTSD in our What You Need To Know About Ketamine For PTSD post.
Understanding Randomized Double-Blinded Studies
So what does it mean for a study to be “randomized” and “double-blinded”. More importantly, why does it matter?
In a randomized study, participants are randomly assigned to different treatment groups (in this case, ketamine or placebo), which helps reduce selection bias. Double-blinded means that neither the participants nor the researchers know who received which treatment until after the study is complete. This design prevents personal bias from influencing the outcome—either in how participants report their symptoms or how researchers interpret results.
These kinds of studies are considered the gold standard in medical research. They help ensure that findings are objective and reliable, giving greater weight to the evidence supporting ketamine as a treatment for PTSD.
From empathic calm to ego dissolution, ketamine journeys vary. Without guidance, these intense states may trigger unresolved trauma in PTSD patients.
Potential Risks of Ketamine Therapy: The Four Types of Experiences
Can ketamine therapy make PTSD symptoms worse?
The short answer is: yes, it’s possible. While ketamine is showing promising results in treating PTSD, it can also induce powerful altered states of consciousness that, for some, may feel overwhelming or even destabilizing.
To better understand this, Dr. Eli Kolp categorized ketamine experiences into four types:
The Empathogenic Experience: Characterized by feelings of comfort, relaxation, reduced ego defenses, and a heightened sense of empathy or connection to others.
Out-of-Body Experiences: A sensation of detachment from one’s physical body, diminished ego boundaries, and even encounters with what some describe as “non-terrestrial beings.”
Near-Death Experiences: A psychological “death” of the self, often including a life review, moral reflection, and a sense of existing purely as consciousness.
Ego-Dissolving Transcendental Experiences: A profound sense of unity with the universe and timelessness, transcending space, identity, and time itself.
These experiences can be incredibly healing when properly prepared for, but they can also be intense especially for individuals with PTSD.
If someone enters a deep dissociative or psychedelic state without proper preparation or support, the experience could potentially trigger unresolved trauma or repressed memories. This is why careful screening, intention-setting, and having a trained, present staff member during infusions are so important in ketamine therapy.
Preparation and integration are essential in ketamine therapy—without them, sessions can feel destabilizing instead of healing.
How to Ensure Safe and Supportive Ketamine Therapy
So, what makes ketamine therapy both safe and effective?
It all comes down to three essential elements: readiness, willingness, and the right set and setting.
If someone isn’t fully ready or hasn’t been adequately prepared for a mind-altering experience, ketamine therapy can feel overwhelming. In some cases, it may even be distressing or re-traumatizing, especially if repressed memories surface unexpectedly.
That’s why mental and emotional preparation before treatment, and thoughtful integration afterward, are an absolute must!
Patients need a support system in place. This may include a trained guide, therapist, or integration coach.
Integration sessions after the infusion can help patients make sense of their experience—especially if it was challenging.
With the right preparation, even a difficult session can become a catalyst for insight and healing.
For some, ketamine may not be the right fit. This is either due to personal preference or medical contraindications. In those cases, another promising treatment option for PTSD is the stellate ganglion block, which we’ll explore next.
Looking for a non–mind-altering option for PTSD? The stellate ganglion block may help reset your nervous system—no altered states required.
Considering a Non-Psychedelic Alternative? Meet the Stellate Ganglion Block?
The stellate ganglion block (SGB) is a non–mind-altering treatment for PTSD that offers an alternative—or even a complement—to ketamine therapy.
So what exactly is it?
SGB is an outpatient procedure in which a local anesthetic is injected near the stellate ganglion which is a cluster of nerves in the neck that plays a key role in the body's fight-or-flight stress response.
The procedure typically takes just 30 to 45 minutes.
Its goal? To "reset" the nervous system, helping to reduce the physical symptoms of PTSD.
Though SGB has been used for over a century to treat chronic pain, more recent studies and patient experiences suggest it may also offer significant relief from PTSD and other mood disorders.
Some individuals experience meaningful symptom improvement after just one treatment.
So if ketamine therapy isn’t the right fit for you or if you're looking to enhance results with a non-psychedelic option, an SGB is a promising avenue worth exploring.
Final Thoughts: Is Ketamine Therapy Right for You?
Let’s recap! Ketamine therapy has shown promise as a rapid and effective treatment for PTSD, supported by a growing body of clinical research.
However, it’s important to remember that ketamine isn’t the right fit for everyone. For those who aren’t emotionally or psychologically prepared, the experience may be overwhelming or even re-traumatizing. That’s why mental preparation, emotional readiness, and post-treatment support are essential components of any successful ketamine therapy journey.
And for those seeking a non–mind-altering option, the stellate ganglion block (SGB) provides a compelling alternative worth considering.
Whether you choose ketamine, SGB, or another path, the key is finding a treatment approach that aligns with your needs, values, and readiness.
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Wondering if ketamine therapy could actually make PTSD symptoms worse? This blog explores the research-backed benefits of ketamine for PTSD, the potential risks of unprepared treatment, and how to ensure safe, effective care. Plus, we introduce an alternative option (stellate ganglion blocks) for those seeking a non-psychedelic approach to healing.
