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The Potential of Ketamine in Treating Alcohol Use Disorder

Article Title: “A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial”

Authors: Elias Dakwar, Frances Levin, Carl L. Hart, Cale Basaraba, Jean Choi, Martina Pavlicova, Edward V. Nunes.

Publication Date: February, 2020

DOI:10.1176/appi.ajp.2019.19070684

Background

Alcohol use disorder (AUD) is a significant global health issue, with limited effective pharmacotherapy and behavioural treatments. Novel approaches to treating AUD are essential to enhance recovery rates. This study investigates whether a single ketamine infusion combined with motivational enhancement therapy (MET) can improve drinking outcomes in individuals with alcohol dependence.

 

Study Overview

This pilot trial involved 40 participants who were randomly assigned to receive either a single ketamine infusion or an active control (midazolam) during the second week of a five-week outpatient MET program. The participants’ alcohol use was monitored over 21 days post-infusion to assess the effectiveness of the treatment.

Key Findings

Increased Abstinence: Participants who received the ketamine infusion were more likely to abstain from alcohol compared to those in the midazolam group.

Delayed Relapse: Ketamine recipients experienced a delayed time to relapse.

Reduced Heavy Drinking: The likelihood of heavy drinking days was lower in the ketamine group compared to the control group.

Good Tolerance: The ketamine infusion was well tolerated with no severe adverse events leading to study withdrawal.

Discussion

The study’s findings suggest that ketamine, combined with MET, can effectively enhance abstinence and reduce heavy drinking in individuals with AUD. The results build on previous research indicating ketamine’s potential in treating substance use disorders by affecting motivation and reducing cravings.

Implications

These promising results suggest that integrating ketamine infusions into behavioural treatment frameworks could offer a new, effective approach to managing AUD. The potential for ketamine to enhance motivation and reduce relapse rates is particularly noteworthy, indicating a possible paradigm shift in addiction treatment.

Potential Application

Clinicians might consider incorporating ketamine infusions into treatment protocols for AUD, especially for patients who have not responded to traditional therapies. However, further research is needed to replicate these findings in larger samples and to understand the long-term effects of such treatment.

Conclusions

This study provides preliminary evidence that a single ketamine infusion, when combined with MET, can significantly improve drinking outcomes in individuals with AUD. The integration of pharmacotherapy and behavioural therapy could represent a promising new direction in addiction treatment.

Reference:

Dakwar, E., Levin, F., Hart, C. L., Basaraba, C., Choi, J., Pavlicova, M., & Nunes, E. V. (2020). A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. American Journal of Psychiatry, 177(2), 125-133. DOI: 10.1176/appi.ajp.2019.19070684.

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