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A pilot study of ketamine among individuals with tobacco use disorder: tolerability and initial impact on tobacco use outcomes.

Janice Chuang, Riley Carpenter Lide, Nikhil Kamath, Alison Oliveto, Merideth Addicott

Journal of Addictive Diseases January 20, 2025 DOI: 10.1080/10550887.2025.2450129 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized, single-blind, placebo-controlled, pilot study Peer reviewed
Sample size 10
Population Individuals with tobacco use disorder recruited from the local community
Intervention Ketamine
Dose 0.5 mg/kg
Duration 20-minute infusion, with assessments during and within an hour after infusion, 24 hours post-infusion, and an eight-day follow-up
Topics Ketamine Esketamine
Keywords Ndma receptor antagonist Glutamate Tobacco Addiction treatment Psychopharmacology Smoking cessation Ketamine therapy Substance dependence
Citations 3
Key points Intravenous ketamine (0.5 mg/kg) produced no significant effects on cigarette smoking, craving, or withdrawal symptoms compared to placebo at 24 hours or eight days post-infusion.

Abstract

There is increasing evidence of ketamine's therapeutic potential in reducing substance use in individuals with substance use disorders. However, its effects on tobacco use disorder are unknown. We investigated the effect of a subanesthetic dose of ketamine on tobacco use. This randomized, single-blind, placebo-controlled, pilot study administered intravenous ketamine to individuals with tobacco use disorder recruited from the local community. Participants were randomized to receive either ketamine (0.5 mg/kg) (n = 6) or saline placebo (n = 4) over 20 min. Primary outcomes included measures of drug safety and tolerability during and within an hour after the infusion. Secondary outcomes included measures of tobacco use, craving, and withdrawal before, and 24-hours after, the drug infusion study day. A follow-up visit occurred eight days after the infusion. Intravenous ketamine was well tolerated with transient side effects. No significant effects were noted on cigarette smoking, craving, or withdrawal symptoms on the post-infusion visit following overnight abstinence or on the follow-up visit (p's > 0.05). Although limited by the small sample size, this pilot study extends previous research on ketamine for substance use disorders. While ketamine was well tolerated in this sample, additional research testing different ketamine doses and administration routes is necessary to determine whether ketamine has therapeutic potential for tobacco use disorder.

Comparable studies

Other randomized controlled trials on ketamine, most cited first.

Study Year Design Participants
Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Healthy human subjects recruited from the community 1994 Randomized controlled trial n = 19
Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode 2013 Randomized controlled trial n = 73
Remifentanil-induced Postoperative Hyperalgesia and Its Prevention with Small-dose Ketamine Patients undergoing major abdominal surgery 2005 Randomized controlled trial n = 75
Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder Patients with chronic PTSD related to a range of trauma exposures 2014 Randomized controlled trial n = 41
Ketamine-Induced Deficits in Auditory and Visual Context-Dependent Processing in Healthy Volunteers Healthy volunteers 2000 Single-blind placebo-controlled study n = 20

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Ketamine Esketamine Addiction