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Ketamine Treatment for Alcohol Use Disorder: A Systematic Review.

Michael Kelson, Justin M Burnett, Amy Matthews, Tony Juneja

Cureus May 1, 2023 DOI: 10.7759/cureus.38498 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Systematic review Case report Peer reviewed
Sample size 854
Population Adult patients with alcohol use disorder, heavy drinkers, or those undergoing alcohol withdrawal
Interventions Ketamine psychotherapy
Topics Addiction Ketamine Esketamine
Keywords Abstinence Alcohol dependence Craving Mental health Relapse Systematic review Withdrawal
Citations 32
Key findings Combination ketamine and psychotherapy treatment showed the most favorable outcomes for abstinence and reduced consumption in people with alcohol use disorder, though results for relapse, craving, and withdrawal were mixed.

Abstract

Alcohol use disorder (AUD) is a chronic, recurrent condition that demonstrates significant heterogeneity in treatment response to first-line agents. Ketamine may have a therapeutic role in substance use disorders; however, research on this topic is limited. The objective of this systematic review is to qualitatively synthesize the current evidence of ketamine treatment for alcohol use disorder and evaluate its efficacy. A systematic review of Medline, PsycINFO, CINAHL, the Cochrane Library, and Google Scholar was performed to identify completed human studies in English or Spanish (from inception to July 2022) that assess the effectiveness of ketamine therapy for alcohol use disorder. This review was registered on the Open Science Framework. Data were descriptively summarized and presented in tables and tested via narrative synthesis methodology. The risk of bias was measured with Cochrane Collaboration tools and a case series quality assessment tool. A total of 11 studies with 854 adult patients in three different countries (the USA, the UK, and Russia) were analyzed. Sample sizes ranged from 5 to 211 people. Seven studies included patients with alcohol use disorder, one study focused on heavy drinkers, and three studies elaborated extensively on alcohol withdrawal. The overall proportion of patients achieving abstinence and reduced consumption was most favorable in people receiving combination ketamine and psychotherapy treatment. The results were mixed with respect to relapse, craving, and withdrawal. Ketamine may be an effective therapeutic modality for people with alcohol use disorders who fail to respond to FDA-approved first-line agents. More robust clinical trials are necessary to provide a more accurate assessment of efficacy, safety profile, and dosing strategies for ketamine utilization in alcohol use disorder.

Comparable studies

Other systematic reviews and meta-analyses on ketamine for addiction, most cited first.

Study Year Design Participants
Ketamine use: a review Ketamine users 2011 Systematic review
Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review 2021 Systematic review
Therapeutic Potentials of Ketamine and Esketamine in Obsessive–Compulsive Disorder (OCD), Substance Use Disorders (SUD) and Eating Disorders (ED): A Review of the Current Literature 2021 Systematic review
Efficacy of ketamine intervention to decrease alcohol use, cravings, and withdrawal symptoms in adults with problematic alcohol use or alcohol use disorder: A systematic review and comprehensive analysis of mechanism of actions. People with harmful alcohol use, alcohol craving, or alcohol withdrawal states,... 2022 Systematic review n = 634
Is there a risk of addiction to ketamine during the treatment of depression? A systematic review of available literature. Adult patients with depression 2025 Systematic review n = 2,174

Citations in the library

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Cites 13

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