Ketamine treatment may be effective for alcohol use disorder, alongside psychological therapy, according to a new study.
A large proportion of people with alcoholism do not benefit from the currently available drug or behavioural treatments.
Professor Celia Morgan of the University of Exeter, UK, and colleagues investigated the use of ketamine, which is a "N-methyl-D-aspartate receptor antagonist". Other drugs in this class have shown promise against Alzheimer’s disease.
In the *American Journal of Psychiatry* yesterday, the team state that ketamine is a promising candidate therapy for several reasons.
First, "substantial evidence supports the antidepressant properties of subanaesthetic doses of ketamine". Second, ketamine might aid alcohol abstinence "by providing a window during which psychological therapies can be more effective". Third, several previous studies have directly investigated this use of ketamine with promising results.
For the clinical trial, 96 men and women with severe alcohol use disorder were randomly given either three weekly ketamine infusions with psychological therapy or with straightforward alcohol education, or placebo with psychological therapy or with alcohol education.
The authors report that the treatment was well tolerated, and no serious adverse events occurred.
"There were a significantly greater number of days abstinent from alcohol in the ketamine group compared with the placebo group at six-month follow-up," they found. The greatest reduction in drinking was seen in the ketamine plus therapy group.
"The findings suggest a possible beneficial effect of adding psychological therapy alongside ketamine treatment," they conclude.
Professor Morgan said: “Alcoholism can destroy lives, and we urgently need new ways to help people cut down.
"This is extremely encouraging, as we normally see three out of every four people returning to heavy drinking within six months of quitting alcohol, so this result represents a great improvement.”
Grabski, M. et al. Ketamine adjunctive to relapse prevention based psychological therapy as a treatment for alcohol use disorder. *American Journal of Psychiatry* 11 January 2022; doi:10.1176/appi.ajp.2021.21030277
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