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Brief report: Ketamine-assisted "bridge therapy" for opioid tapering in complex cases.

Mariana C De Oliveira, Cláudia C De Araujo Palmeira, André B Negrão, Ziyad A Hadi, Julia R Arana, Rita De Cássia Ferreira Duarte, Joice L P Da Silva, Gustavo K Matsui, João F D Rapozero, Douglas H Crispim, André Malbergier, João M Castaldelli-Maia

American Journal on Addictions January 28, 2026 DOI: 10.1111/ajad.70131 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 25-year-old woman with opioid use disorder, chronic pain, and major depressive disorder
Intervention Intravenous ketamine infusions
Dose 0.5 mg/kg weekly
Duration 8-week protocol
Topics Esketamine Ketamine
Citations 1
Key findings Ketamine-assisted bridge therapy enabled a 50% reduction in methadone dosage with improvements in pain, cravings, withdrawal symptoms, and psychotherapy engagement.

Abstract

Opioid use disorder (OUD) presents major challenges, especially when combined with chronic pain and psychiatric comorbidities. A 25-year-old woman with OUD, chronic pain, and major depressive disorder underwent an 8-week protocol of intravenous ketamine infusions (0.5 mg/kg weekly) as an adjunct to opioid tapering. Methadone dosage was reduced by 50%, with improved pain and craving control, reduced withdrawal symptoms, and greater psychotherapy engagement. Ketamine-assisted "bridge therapy" treatment may support opioid tapering in complex cases. This is a novel report to document a multifaceted improvement in this specific comorbidity cluster.

Comparable studies

Other case reports and case series on ketamine, most cited first.

Study Year Design Participants
The destruction of the lower urinary tract by ketamine abuse: a new syndrome? Young recreational abusers of street-ketamine in Hong Kong referred to urology units 2008 Retrospective case series n = 59
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Treatment of compulsive behaviour in eating disorders with intermittent ketamine infusions Chronic and treatment-resistant eating disorder patients 1998 Case series n = 15
Oral Administration of the NMDA Receptor Antagonist S-Ketamine as Add-On Therapy of Depression: A Case Series Four depressed patients taking standard antidepressants 2009 Case series n = 4
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment‐resistant depression Patients with enduring eating disorders and treatment-resistant depression 2021 Case series n = 4

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