January 11, 2022
2 minutes to read
Source / Disclosures
Disclosures: Grabski claims to have received royalties for the distribution of the KARE therapy license. Please see the study for relevant financial information from all authors.
Ketamine and mindfulness training may be effective as an add-on treatment for patients with alcohol use disorders, according to a double-blind, placebo-controlled phase 2 clinical trial, published in the American Journal of Psychiatry.
“Depressive symptoms are common in people who start treatment for AUD, and the likelihood of alcohol relapse is high in patients with such symptoms. Ketamine may promote abstinence from alcohol by temporarily relieving depressive symptoms during the period of high risk of relapse in the weeks following detoxification ”, Meryem Grabski, PhD, from the Psychopharmacology and Addiction Research Center at the University of Exeter in the UK, and his colleagues wrote
“Ketamine may give a temporary boost to synaptogenesis and neurogenesis, which may allow psychological therapies and new addiction management strategies to integrate more easily,” they added.
Grabski and colleagues sought to compare the safety and impact of ketamine with placebo in reducing cravings and promoting abstinence in patients diagnosed with alcohol use disorder (AUD). Additionally, efforts have been made to evaluate the effectiveness of combining mindfulness therapy with ketamine and alcohol education as adjunct treatments. The trial included 96 patients aged 18 to 65 who were diagnosed with severe alcohol use disorder. Trial participants were recruited for the study through social media, mainstream media advertisements, and primary and secondary drug and alcohol care services. All participants were required to refrain from drinking alcohol for at least 24 hours before the start of the test and display a reading of 0.0 on a breathalyzer on the initial visit to the test.
The researchers randomly assigned participants to one of four treatment cycles: one group received three weekly infusions of ketamine (0.8 mg / kg iv over 40 minutes) plus psychological therapy lasting 1, 5 o’clock ; a second group received three saline infusions plus psychological therapy; the third group received three ketamine infusions and one and a half hour alcohol education; and the last group received three saline infusions and alcohol education.
Results were based on the self-reported percentage of alcohol-free days, as well as any relapse during a 6-month follow-up assessment. A watch bracelet was placed on each participant on the first or second of 10 visits scheduled by clinical staff and removed on the eighth visit to confirm the report.
The results showed an overwhelming difference in the difference between the number of days of abstinence recorded by the ketamine group compared to the placebo group at 6-month follow-up (mean difference = 10.1%, 95% CI = 1.1 , 19.0). The greatest reduction in the total number of days abstinence was observed when comparing the ketamine plus therapy group with the saline plus education group (15.9%, 95% CI = 3.8, 28.1). However, no significant difference was recorded in the relapse rate between the ketamine and placebo cohorts.
The researchers wrote that no serious side effects were reported during the administration of the drug by any of the participants.
“The fact that ketamine can reduce both alcohol consumption and depression in AUD is therapeutically encouraging,” wrote Grabski and colleagues. “Although a clear link between depression and AUD is recognized, alcoholism and mental health services continue to struggle to meet the needs of dual diagnosis patients, so ketamine may be a solution to this comorbidity. for a long time. ”