Ketamine for substance use disorders: a systematic review and meta-analysis

Area of Science:

• Pharmacology
• Psychiatry
• Public Health

Background:

• Substance use disorder (SUD) presents a significant global health challenge with limited effective treatments.
• Ketamine is emerging as a potential therapeutic agent for SUD.
• Existing research lacks a comprehensive meta-analysis on ketamine's efficacy for SUD.

Purpose of the Study:

• To systematically evaluate the efficacy of ketamine in treating substance use disorder.
• To assess the safety and acceptability of ketamine treatment for SUD.
• To synthesize evidence from randomized controlled trials (RCTs) through meta-analysis.

Main Methods:

• A systematic search of multiple databases was conducted for RCTs investigating ketamine for SUD.
• Abstinence rates were the primary outcome measure.
• Adverse events and dropout rates were assessed to evaluate safety and acceptability.
• A random-effects model was employed for the meta-analysis.

Main Results:

• Fifteen RCTs involving 798 participants were included in the review.
• Ketamine significantly improved abstinence rates at less than one month (OR = 3.27).
• No significant differences were found in abstinence rates at 1-6 months, dropout rates, or adverse events between ketamine and control groups.
• Evidence regarding safety was limited and insufficient for conclusive determination.

Conclusions:

• Ketamine demonstrates a short-term efficacy signal for treating substance use disorder.
• The current evidence is insufficient to conclusively establish the long-term efficacy and safety of ketamine for SUD.
• Further rigorous research is warranted to confirm ketamine's therapeutic role in SUD management.