Dakwar and colleagues1 undertook a pilot trial to test the effects of ketamine combined with motivational enhancement therapy on adults with alcohol dependence. The participants (N = 40) were predominantly white and mostly middle-aged and unemployed. On average they were consuming five drinks daily.
Participants were randomized to either ketamine (n = 17) or midazolam (n = 23). In the second week of a five-week motivational enhancement therapy program, participants received either a single 52-minute infusion of ketamine (0.71 mg/kg; n = 17) or midazolam (0.025 mg/kg; n = 23).
Following administration, alcohol use was assessed with abstinence, confirmed by urine ethyl glucuronide testing. A longitudinal model was used to gauge daily abstinence from alcohol over 21 days following ketamine administration.
Compared with midazolam, the ketamine infusion significantly improved abstinence. Moreover, it delayed the time to relapse and reduced the likelihood of heavy drinking days. Infusions were well tolerated, with no discontinuations due to adverse effects.
1. Dakwar E, Levin F, Hart CL, et al. A single ketamine infusion combined with motivational enhancement therapy for alcohol use disorder: a randomized midazolam-controlled pilot trial. Am J Psychiatry. 2020;177:125-133.