Mystical-type experiences occasioned by ketamine mediate its impact on at-risk drinking: Results from a randomized, controlled trial.
Rebecca L Rothberg, Nour Azhari, Nancy A Haug, Elias Dakwar
Journal of psychopharmacology (Oxford, England) February 1, 2021 DOI: 10.1177/0269881120970879 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 40 |
| Population | Alcohol-dependent adults interested in treatment |
| Interventions | Ketamine Midazolam Motivational enhancement therapy |
| Dose | 52-minute infusion |
| Duration | 5-week motivational enhancement therapy regimen; infusion on quit-day in week 2; alcohol use monitored for 3 weeks post-infusion |
| Topics | Addiction Ketamine Mystical experience Esketamine |
| Keywords | Addiction treatment At-risk drinking Hallucinogen Motivational enhancement therapy Psychedelic Spirituality |
| Citations | 95 |
| Key findings | Mystical-type effects of ketamine, but not dissociation, mediated the reduction in at-risk drinking behavior in alcohol-dependent adults. |
Abstract
Sub-anesthetic ketamine administration may be helpful for substance use disorders. Converging evidence suggests that the efficacy of ketamine for certain conditions may implicate a subset of its psychoactive effects. The aim of this analysis is to evaluate whether the mystical-type effects of ketamine are critical for clinical efficacy in alcohol-dependent individuals. In this secondary analysis, we determine if a subset of the psychoactive effects of ketamine, the so-called mystical-type experience, mediates the effect of ketamine, when combined with motivational enhancement therapy, on at-risk drinking behavior in alcohol-dependent individuals interested in treatment. Forty alcohol dependent adults were randomized to either a 52-minute infusion of ketamine or midazolam, which they received on a designated quit-day during the second week of a five-week motivational enhancement therapy regimen. Psychoactive effects were assessed following the infusion, and alcohol use was monitored for the subsequent 3 weeks at each twice-weekly visit. We found that ketamine leads to significantly greater mystical-type effects (by Hood Mysticism Scale) and dissociation (by Clinician Administered Dissociative States Scale) compared to the active control. Ketamine also led to significant reduction in at-risk drinking. The Hood Mysticism Scale, but not Clinician Administered Dissociative States Scale score, was found to mediate the effect of ketamine on drinking behavior. This trial adds evidence to the literature on the importance of mystical-type experiences in addiction treatment. Future research should continue to investigate the relationship between the psychoactive effects of psychedelic therapeutics and clinical outcomes for other substance use and mental health disorders.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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Mystical-type effects of ketamine, but not dissociation, mediated the reduction in at-risk drinking behavior in alcohol-dependent adults.
Synthesized
Comparable studies
Other randomized controlled trials on ketamine for addiction, most cited first.