Approximately 45 percent of PTSD patients do not improve with the only two FDA-approved medications for the disorder — both antidepressants that can take weeks or months to produce even partial relief (Abdallah et al., 2022). For veterans and first responders who have already been through multiple failed treatments, that statistic is not abstract. At The Invictus Clinic in Marietta, Georgia, we work with patients who have exhausted the standard options, and we want you to understand what the research says about IV ketamine as a potential path forward.
Why Standard PTSD Treatments Fall Short for So Many Veterans
Post-traumatic stress disorder, or PTSD, is a chronic condition that develops after exposure to traumatic events and can cause intrusive memories, nightmares, avoidance behaviors, emotional numbness, and hypervigilance. Veterans and active-duty military face some of the highest rates of PTSD among any population, and first responders — including law enforcement, firefighters, and emergency medical personnel — are not far behind (Ragnhildstveit et al., 2023).
The two medications currently approved by the FDA to treat PTSD, sertraline and paroxetine, are selective serotonin reuptake inhibitors (SSRIs), meaning they work by increasing the availability of serotonin in the brain. For many patients, these medications offer meaningful relief. But research suggests that a substantial portion of PTSD patients either do not respond to them or respond only partially, leaving significant symptoms in place (Abdallah et al., 2022). When that happens after multiple adequate medication trials — meaning the right dose, for a sufficient duration — clinicians use the term treatment-resistant PTSD.
The reasons for treatment resistance are not fully understood, but one important factor involves the glutamate system. Glutamate is the brain’s primary excitatory neurotransmitter, and there is growing evidence that disruptions in glutamate signaling play a role in PTSD — a pathway that SSRIs do not directly address (Ragnhildstveit et al., 2023). Ketamine, an NMDA receptor antagonist (a drug that blocks a specific type of glutamate receptor), works through this system, which is one reason researchers have been investigating it as a potential option for patients who haven’t responded to first-line treatments.
What the Research Shows
The clinical evidence for ketamine and PTSD is still developing, and results vary by individual — but there are meaningful signals in the published research. In 2014, the first randomized controlled trial of IV ketamine for chronic PTSD found significant and rapid reduction in PTSD symptom severity compared to a placebo control just 24 hours after a single infusion (Feder et al., 2014). That study was described at the time as the first evidence of rapid ketamine efficacy for chronic PTSD.
A follow-up study from the same research group — the first randomized controlled trial of repeated ketamine infusions for chronic PTSD — assigned participants with chronic PTSD to receive either six infusions of IV ketamine or a psychoactive placebo over two consecutive weeks. The ketamine group showed significantly greater improvement on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), a clinician-rated measure of PTSD severity, compared to the placebo group at the end of the two-week treatment period. Among those who responded, improvement was observed as early as 24 hours after the first infusion (Feder et al., 2021).
Research has also specifically examined veterans and active-duty military. A large, multi-site, double-blind, randomized, placebo-controlled clinical trial studied repeated IV ketamine infusions in veterans and service members with PTSD who had not responded to prior antidepressant treatment. Primary outcomes for PTSD symptoms did not reach statistical significance, but secondary analyses suggested rapid antidepressant effects at standard dosing, and ketamine was found to be safe and well tolerated throughout the trial, with dissociative side effects — temporary alterations in perception — resolving within two hours of each infusion (Abdallah et al., 2022).
A 2023 systematic review synthesizing the full body of clinical evidence characterized the overall picture as showing “encouraging signals of therapeutic safety, efficacy, and durability” for ketamine in PTSD, while noting that the heterogeneity of study populations and dosing protocols means more research is needed (Ragnhildstveit et al., 2023). That is an honest description of where the science stands: promising, actively developing, and not yet settled. Patients interested in the broader role of ketamine clinics in PTSD care may also find our post on the role of ketamine clinics in treating PTSD a useful companion read.
How We Approach This at The Invictus Clinic
We are a ketamine and infusion therapy clinic founded and operated by two anesthesia specialists — Brandon Grinage, MD, a board-certified anesthesiologist, and Wesley Karcher, MSN, CRNA, a certified registered nurse anesthetist with decades of combined clinical experience. That anesthesia background matters for ketamine treatment specifically, because safe administration, appropriate dosing, and careful monitoring throughout the infusion are not optional — they are foundational to the process. You can learn more about our team and training before your consultation.
Every patient begins with a free consultation to review their full medical and psychiatric history, prior treatment trials, and current medications. We do not take a one-size-fits-all approach. Dosing is individualized, and we monitor vital signs throughout every infusion. Our treatment rooms are private and designed to be calm and comfortable, and a family member or trusted person is welcome to stay with you during your infusion.
We have a particular commitment to veterans and first responders. We offer a 25% military discount on IV ketamine, NAD+ infusions, and vitamin infusions for active military, veterans, and first responders — because we believe that those who have carried the weight of service deserve access to advanced care.
Addressing Common Concerns
One concern we hear often is about cost. IV ketamine is not typically covered by insurance for PTSD, and that is a real barrier we take seriously. Our per-treatment range is $400–$1,000, and we offer CareCredit financing for patients who need it. We also offer a 15% discount for patients who pay upfront for their initial infusion series. We work with Anthem Blue Cross Blue Shield, Aetna, and Medicare on coverage exploration, and our team will walk through the financial side of any treatment before you commit to anything.
Another concern involves the perception of ketamine itself. Ketamine has been FDA-approved as an anesthetic since 1970 and has more than 50 years of use in medical settings. At subanesthetic doses, administered intravenously in a monitored clinical environment, it functions very differently than recreational use. The dose, setting, route of administration, and continuous monitoring are all distinct, and our providers — both anesthesia specialists — are trained specifically in safe administration. That said, ketamine is not appropriate for everyone, which is exactly why we conduct a thorough evaluation before recommending it. Contact us to schedule your free consultation.
Frequently Asked Questions
Is IV ketamine a proven treatment for PTSD?
Ketamine is not FDA-approved specifically for PTSD, and the research is still developing. However, randomized controlled trials have shown significant rapid reductions in PTSD symptoms in some patient populations, and the overall safety profile in clinical settings has been consistently favorable across studies. We discuss the current evidence and individual candidacy in full during the free consultation. Results vary by individual.
What does the ketamine infusion experience actually feel like?
During an infusion, some patients experience mild dissociation — a temporary sense of detachment or altered perception — which typically peaks around 30–40 minutes into the infusion and resolves within two hours. Most patients describe the overall experience as manageable, and our providers are present throughout to monitor and support you. You will need someone to drive you home afterward.
How many infusions does PTSD treatment require?
Mental health infusions typically run 40–60 minutes. Research protocols have used series of six infusions over two weeks, though individual treatment plans are tailored based on your history and response. We assess your progress throughout and adjust accordingly.
Does ketamine work the same way for veterans as for civilians?
The clinical evidence is mixed in veteran and military populations specifically. One large trial did not find significant dose-related effects on PTSD symptoms in veterans and service members, while secondary analyses suggested benefits at certain doses (Abdallah et al., 2022). We discuss what this means for individual candidacy honestly during evaluation — we do not overstate what the research shows.
Can I combine ketamine treatment with my existing therapy or medications?
Many patients continue psychotherapy and existing medications alongside ketamine treatment. Some medication combinations require review before treatment begins. We go through your full medication list during the consultation and coordinate with your other providers as needed.
Key Takeaways
- Treatment-resistant PTSD is a clinical designation for patients who have not responded adequately to multiple antidepressant trials; it is not a sign that recovery is impossible.
- SSRIs, the only FDA-approved PTSD medications, work through the serotonin system and do not address the glutamate pathway now understood to play a role in PTSD — which is the pathway ketamine targets.
- Randomized controlled trials have demonstrated rapid reductions in PTSD symptoms following IV ketamine infusions, with benefits observed as early as 24 hours after the first infusion in some populations (Feder et al., 2014; Feder et al., 2021).
- Ketamine is not FDA-approved for PTSD, the research continues to develop, and results vary by individual — but the safety profile across clinical trials has been consistently favorable.
- Veterans and first responders receive a 25% discount on IV ketamine at The Invictus Clinic, and our free consultation is the right starting point to determine whether you may be a candidate.
If you have been through multiple treatments for PTSD without adequate relief, your history is not a dead end — it is information that helps us understand what to explore next. We offer free consultations at our Marietta, Georgia clinic, where our team will review your full treatment history and give you an honest picture of your options. Call us at 770-580-1042 or visit our website to schedule your consultation, Monday through Friday, 9AM–5PM, and Saturdays by appointment.
References
Abdallah, C. G., Roache, J. D., Gueorguieva, R., Averill, L. A., Young-McCaughan, S., Shiroma, P. R., Purohit, P., Brundige, A., Murff, W., Ahn, K. H., Sherif, M. A., Baltutis, E. J., Ranganathan, M., D’Souza, D., Martini, B., Southwick, S. M., Petrakis, I. L., Burson, R. R., Guthmiller, K. B., López-Roca, A. L., Lautenschlager, K. A., McCallin, J. P., Hoch, M. B., Timchenko, A., Souza, S. E., Bryant, C. E., Mintz, J., Litz, B. T., Williamson, D. E., Keane, T. M., Peterson, A. L., & Krystal, J. H. (2022). Dose-related effects of ketamine for antidepressant-resistant symptoms of posttraumatic stress disorder in veterans and active duty military. Neuropsychopharmacology, 47(8), 1574–1581. https://pmc.ncbi.nlm.nih.gov/articles/PMC9205895/
Feder, A., Parides, M. K., Murrough, J. W., Perez, A. M., Morgan, J. E., Saxena, S., Kirkwood, K., Aan Het Rot, M., Lapidus, K. A. B., Wan, L.-B., Iosifescu, D., & Charney, D. S. (2014). Efficacy of intravenous ketamine for treatment of chronic posttraumatic stress disorder: a randomized clinical trial. JAMA Psychiatry, 71(6), 681–688. https://pubmed.ncbi.nlm.nih.gov/24740528/
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://pmc.ncbi.nlm.nih.gov/articles/PMC10316213/
Ragnhildstveit, A., Roscoe, J., Bass, L. C., Averill, C. L., Abdallah, C. G., & Averill, L. A. (2023). The potential of ketamine for posttraumatic stress disorder: a review of clinical evidence. Therapeutic Advances in Psychopharmacology, 13. https://pmc.ncbi.nlm.nih.gov/articles/PMC9989422/
Medical Disclaimer: The information in this blog is for educational purposes only and does not constitute medical advice. IV ketamine therapy for PTSD should only be considered under the supervision of a licensed medical provider who is familiar with your full medical and psychiatric history. Ketamine is not FDA-approved for PTSD treatment. Individual results vary, and not all patients are appropriate candidates. If you are experiencing a mental health crisis or thoughts of self-harm, please call or text 988 to reach the Suicide and Crisis Lifeline, or go to your nearest emergency room.
