Adjunctive ketamine safe, effective in alcohol use disorder

Treatment with three infusions of ketamine is acceptable among patients with alcohol use disorder and results in more days of abstinence from alcohol at 6-month follow-up, a study has shown.

“Early evidence suggests that ketamine may be an effective treatment to sustain abstinence from alcohol,” the investigators said.

In this double-blind, placebo-controlled phase II clinical trial, the investigators randomized patients with severe alcohol use disorder to one of four conditions: 1) three weekly ketamine infusions (0.8 mg/kg i.v. over 40 minutes) plus psychological therapy, 2) three saline infusions plus psychological therapy, 3) three ketamine infusions plus alcohol education, or 4) three saline infusions plus alcohol education.

Self-reported percentage of days abstinent and confirmed alcohol relapse at 6-month follow-up were the primary endpoints.

Of the 96 patients (mean age 44.07 years) included in the intention-to-treat analysis, 35 were women. Treatment was well tolerated, with no serious adverse events associated with the drug reported.

Consistent with a proof-of-concept study, a significantly greater number of days abstinent from alcohol were observed in the ketamine group compared with the placebo group at 6-month follow-up, even though confidence intervals (CIs) were wide (mean difference, 10.1 percent, 95 percent CI, 1.1‒19.0).

Reduction was highest in the ketamine plus therapy group compared to the saline plus education group (mean difference, 15.9 percent, 95 percent CI, 3.8‒28.1). Moreover, no significant between-group difference was noted in relapse rate.

“The findings suggest a possible beneficial effect of adding psychological therapy alongside ketamine treatment,” the investigators said.