- Results from new studies suggest that ketamine may be effective in treating alcohol use disorder.
- Researchers found that when participants were treated with ketamine instead of midazolam, a sedative that helps with alcohol withdrawal, they had higher rates of stopping drinking following treatment.
- They were also less likely to relapse, had fewer days of drinking, and had fewer days of heavy drinking.
Once derided as a “club drug,” the anesthetic ketamine is facing a surge of interest from doctors and researchers who say it could treat certain psychiatric disorders. The most prominent among them: depression.
The first study, published earlier this month in The American Journal of Psychiatry, was a pilot study, the first of its kind, to test the effects of ketamine and mindfulness practice against a control for alcohol use disorder.
The study included 40 participants who, on average, consumed about 5 drinks per day. Most of the participants were white, and most were employed.
Participants were randomly assigned to either receive a single infusion of ketamine along with a 5-week regimen of motivational enhancement therapy, or midazolam, a sedative that helps with alcohol withdrawal, and the same therapy.
Researchers found that participants who received ketamine rather than midazolam had higher rates of abstinence (stopping drinking) following treatment, were less likely to relapse, had fewer days of drinking, and had fewer days of heavy drinking.
The beneficial results of the ketamine also persisted for several weeks after the single dose infusion.
Dr. Elias Dakwar, an associate professor of clinical psychiatry at Columbia University Medical Center and first author of the study, said he became interested in ketamine as a potential treatment for alcohol use disorder after seeing good results from using the
“It made sense to try it with alcohol users,” he said.
“Number two, based on what we were seeing with [cocaine users], it seemed that ketamine was working in a very different way. That a single dose would have these very robust and long-lasting effects. Just a single dose. That’s not really seen with any other medicines,” he said.
Dakwar and his team also noted a synergistic effect between the ketamine and the motivational enhancement therapy, a type of therapy that, as the name suggests, focuses on improving an individual’s motivation to stop using alcohol.
The ketamine appeared to have a profound effect on improving patient motivation for quitting.
But affecting motivation doesn’t appear to be the only way that ketamine works on the brain to help quit alcohol.
In a separate study, published in the journal
“Maladaptive reward memories comprise associations between trigger ‘cues’ in the environment and drug reward. For people who don’t use drugs, a relatable example would be smelling some delicious food and suddenly feeling hungry or having a craving to eat that food,” the study’s first author, Ravi K. Das, PhD, a psychopharmacologist at University College London, told Healthline.
He further explained, “Those kind of learned responses are what can underlie relapse in a lot of cases and are what we’re trying to break down.”
Das and his team included 90 participants in their study who were heavy drinkers. It’s important to note that none of the participants were formally diagnosed with alcohol use disorder, nor were they actively seeking treatment.
Nonetheless, Das notes that the group had a “physically harmful level of alcohol consumption.”
Participants were exposed to drinking cues by using images of beer, and even being allowed to consume beer in the lab. Several days later, they were given a ketamine infusion to see the effects on how participants reacted to these cues.
Researchers found that a single infusion of ketamine produced a substantial reduction in the overall enjoyment of and desire to drink beer. And these effects were noticeable throughout a 9-month follow-up period after the initial infusion.
“Certain drugs, like ketamine, may be able to interfere with the restabilization of memories. If you can block the restabilization process with a drug like ketamine, you can potentially directly weaken MRMs and reduce their propensity to trigger relapse,” said Das.
However, he notes that such demonstrations have primarily been shown in lab animals thus far, with few undertaken in humans.
He also reiterates that the study was experimental in nature and not a clinical trial. As such, the significance of the findings would need to be replicated with more rigorous controls.
Scott Krakower, DO, assistant unit chief, psychiatry at Zucker Hillside Hospital, Glen Oaks, New York, who wasn’t affiliated with Das’ research, but reviewed it, stated, “Ketamine… has been useful with treating refractory depression and may play a role in the reward response pathway. When used in conjunction with other interventions, it may be potentially useful in treating alcoholism one day.”
However, we’re not there — yet.