By Dr. Tiago Reis Marques
Over the past year, the pandemic has taken a massive psychological toll on people across the world, especially among healthcare workers. Those on the frontlines started experiencing symptoms of severe stress, anxiety and depression, which evolved into post-traumatic stress disorder (PTSD) for many.
Healthcare workers endured traumatic events on a regular basis throughout the pandemic, being faced with anxiety over virus exposure, witnessing the death of numerous patients, battling burnout and even having to make the choice of which patient is more in need of scarce medical equipment. As a direct result, an international study of over 900 healthcare workers that have cared for patients infected with COVID-19 found that more than half experienced moderate to severe symptoms of PTSD.
Despite vaccination rates climbing and restrictions lifting, we’re going to continue seeing a rise in PTSD cases as healthcare workers and those who experienced loss or other life altering events continue processing what they experienced during the pandemic. This will likely result in a heightened demand for PTSD treatments, which typically include a combination of therapy and antidepressants. However, as more cases are identified and treated, the limited efficacy of these available treatments will become apparent. There is a glaring need for alternative therapies to treat PTSD, which is why it’s so important to continue raising awareness about the severity and symptoms of this disorder as well as novel treatment options available, including ketamine, which can greatly help in their recovery.
What is PTSD?
Post-traumatic stress disorder (PTSD) is a psychiatric disorder that occurs in individuals that have witnessed or gone through a traumatic event. Examples of these traumatic events include a serious accident, a natural disaster, rape, a terrorist act and even situations where someone is threatened with death. To be diagnosed with PTSD, you’ll have to have had direct or indirect but close exposure to any one of the events listed. For many, the pandemic can be considered a traumatic event or experience because of the undue stressors it added to most people’s lives.
What are the symptoms of PTSD?
PTSD can be a serious illness if left untreated with symptoms that vary in severity and are typically separated into these four categories:
Intrusive memories or flashbacks
This symptom includes recurrent, involuntary memories and distressing dreams which can even present themselves as disturbing flashbacks of the traumatic event itself. At times, these flashbacks can seem so realistic that they will trick a person into thinking they are re-experiencing the event. Someone can also undergo emotional distress or physical reactions to something that reminds them of the event.
Changes in Memory and Mood
This symptom presents itself as the inability to recall notable aspects of a traumatic event and experiencing negative thoughts and emotions which lead to inaccurate recollections. This can include warped thoughts about the consequence or cause of an event, causing someone to blame themselves or others. People suffering from PTSD may also feel detached and unable to connect with others or experience positive emotions.
This includes increased irritability, being easily startled, an increase in angry outbursts; behaving recklessly; paranoia. Those suffering from PTSD can also experience trouble sleeping and concentrating.
When a person avoids reminders of the traumatic event they experienced or begins avoiding people, places or certain activities, this is an indicator that they are suffering from PTSD. Avoidance can also include avoiding any discussion about the event that caused their trauma and how it has impacted them.
Inefficacy of Treatments+ Need For Alternative Treatments
As mentioned above, coping with PTSD usually requires a combination of both psychotherapy and antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs). However, the efficacy of SSRIs is limited with an overall response rate of approximately 60%, with only 20% to 30% of patients achieving complete remission. Due to the limited efficacy of these treatments, many patients struggling with PTSD continue to suffer with no relief and are subject to poor quality of life and sometimes suicidal thoughts.
The need for alternative therapies for PTSD is imperative to the health and well-being of these individuals. Recently, there have been attempts to repurpose some existing drugs for the treatment of this disorder.
One alternative promise in treating PTSD is ketamine. Ketamine is an anesthetic drug that blocks a brain receptor called N-methyl-d-aspartate (NMDA) receptor, which has been shown to be involved in the neurobiology of several psychiatric disorders. Recently, two randomized clinical trials have shown efficacy of intravenous ketamine in reducing PTSD symptoms in patients with chronic PTSD. Moreover, ketamine infusions have shown to reduce PTSD symptom severity significantly and rapidly, sometimes even as fast as 24 hours after treatment. What’s more, ketamine was also associated with reduction in comorbid depressive symptoms and with improvement in overall clinical presentation, proving to be a viable and novel treatment for PTSD.
In addition to Ketamine, another potential breakthrough in PTSD treatment comes from the use of methylenedioxymethamphetamine (MDMA). A recent Phase 3 clinical trial of MDMA-assisted therapy for patients with severe, chronic PTSD found that the drug when combined with therapy is an effective treatment, with more than half of the participants who received MDMA no longer qualifying for a PTSD diagnosis.
Given these findings supporting the validity and efficacy of alternative drugs and therapies, there has never been more of a need to make these types of treatments accessible beyond clinical trials.
How ketamine infusion clinics will become commonplace in the US healthcare system
The growing demand for alternative treatments and therapies for PTSD and many other mental health disorders will only drive the adoption of ketamine infusion clinics in the US healthcare system. Ketamine has proven to aid those suffering from depressive disorders and has already been used to treat 10,000-15,000 patients worldwide, exhibiting its success compared to traditional treatments for depression. Already being administered by doctors we can expect to see interest in and access to these types of treatment options continue to grow.
PTSD continues to present itself as a major public health concern affecting many worldwide, and its prevalence will continue to climb post-pandemic due to the trauma endured over the last year. Widespread adoption and use of emerging and alternative therapies, including MDMA and ketamine, in the US healthcare system can dramatically increase recovery rates of debilitating mental disorders and improve quality of life for millions of Americans.
Dr. Tiago Reis Marques is a Psychiatrist and CEO of Pasithea Therapeutics