Remission from behavioral dysregulation in a child with PTSD after receiving procedural ketamine

Ketamine, an N-methyl-D-aspartate-type glutamate receptor antagonist, has long been used for anesthesia and has recently been investigated for its rapid antidepressant effects in adults with treatment-resistant depression and posttraumatic stress disorder (PTSD). We report a case of a child with PTSD and episodes of severe aggression and emotional dysregulation that were refractory to multiple medical and behavioral interventions. This child demonstrated sustained (8-13 days) remission from these symptoms when exposed to ketamine in the context of 2 procedures. We review the sparse literature on the uses of ketamine for behavioral purposes in children. This case suggests that ketamine should be further explored as a potential treatment option for children with severe refractory behavioral aggression.