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A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized
Elias Dakwar1, Frances Levin1, Carl L Hart1
1New York State Psychiatric Institute, Columbia University Medical Center, New York (Dakwar, Levin, Hart, Nunes); the Department of Psychology, Columbia University, New York (Hart); the Division of Mental Health Data Science, New York State Psychiatric Institute, New York (Basaraba, Choi); the Department of Biostatistics, Mailman School of Public Health, Columbia University, New York (Pavlicova).
A single ketamine infusion improved drinking outcomes for adults with alcohol dependence, increasing abstinence and reducing heavy drinking days. This pilot study suggests ketamine as a potential new treatment for alcohol use disorder when combined with behavioral therapy.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Current pharmacotherapy and behavioral treatments for alcohol use disorder (AUD) have limited effectiveness.
- Novel treatment mechanisms are needed to improve outcomes for individuals with AUD.
- This study explores ketamine as a potential adjunct treatment for AUD.
Purpose of the Study:
- To investigate the effects of a single subanesthetic ketamine infusion on drinking outcomes in adults with alcohol dependence.
- To assess if ketamine, when combined with motivational enhancement therapy, can improve abstinence rates and reduce heavy drinking days.
- To evaluate the safety and tolerability of ketamine infusions in this patient population.
Main Methods:
- A pilot randomized controlled trial involving 40 adults with alcohol dependence.
- Participants received either ketamine (0.71 mg/kg) or midazolam (0.025 mg/kg) intravenously during a 5-week motivational enhancement therapy program.
- Drinking outcomes were assessed using the timeline followback method and confirmed by urine ethyl glucuronide tests over 21 days post-infusion.
Main Results:
- Ketamine significantly increased the likelihood of alcohol abstinence compared to midazolam.
- Ketamine administration was associated with a delayed time to relapse.
- Participants receiving ketamine showed a reduced likelihood of heavy drinking days, and the infusions were well-tolerated.
Conclusions:
- A single subanesthetic ketamine infusion shows promise in improving drinking measures for individuals with alcohol dependence undergoing motivational enhancement therapy.
- These findings suggest a potential new direction for integrated pharmacotherapy-behavioral treatments for alcohol use disorder.
- Further research with larger sample sizes is warranted to confirm these preliminary results.
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