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Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems.

Emily M Gent, Joshua W. Bryan, Maisy A Cleary, Tegan I Clarke, Harry D Holmwood, Rania O Nassereddine, Chris Salway, Simon Depla, Sarah Statton, Joy Krecké, Celia Ja Morgan

Journal of Psychopharmacology June 1, 2024 DOI: 10.1177/02698811241254834 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Double-blind pilot randomized controlled trial Pilot study Peer reviewed
Sample size 28
Population Individuals with alcohol problems
Interventions Esketamine hydrochloride (AWKN002: 115.1 mg) Vitamin C (placebo)
Dose 115.1 mg
Duration 2 weeks of daily MBI
Topics Addiction Esketamine Meditation Ketamine
Keywords Engagement Ketamine-assisted therapy Mindfulness-based intervention Addiction therapy Psychedelic medicine Mindfulness meditation Substance use treatment Ketamine therapy
Citations 20
Key findings Esketamine enhanced psychological engagement with daily mindfulness-based intervention and led to transient decreases in alcohol cravings compared to placebo.

Abstract

Alcohol use disorder (AUD) is a major public health issue, posing harmful consequences for individuals and society. Recent advances in addiction research have highlighted the therapeutic potential of ketamine-assisted therapy for AUD. However, the exact mechanisms underlying its effectiveness remain unknown. This double-blind, pilot study aimed to investigate esketamine combined with mindfulness-based intervention (MBI) to examine whether esketamine enhances engagement in MBI for individuals with alcohol misuse problems and whether enhanced engagement has any impact on alcohol-related outcomes. In all, 28 individuals with alcohol problems were randomly assigned to receive sublingual esketamine hydrochloride (AWKN002: 115.1 mg) or vitamin C (placebo) in an oral thin film and took part in 2 weeks of daily MBI. Participants were assessed on various self-report measures, including mindfulness, engagement in MBI (physical and psychological), alcohol cravings and consumption. Esketamine enhanced psychological engagement with a daily MBI, compared to placebo, and led to transient decreases in alcohol cravings. Esketamine also resulted in significantly greater mystical experiences and dissociative states compared to placebo. The findings suggest that esketamine may improve treatment outcomes when combined with mindfulness-based therapies through its ability to increase engagement with meditative practice.

Comparable studies

Other randomized controlled trials on ketamine for addiction, most cited first.

Study Year Design Participants
Ketamine psychotherapy for heroin addiction: immediate effects and two-year follow-up. Detoxified heroin-addicted patients 2002 Randomized controlled trial n = 70
A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. Adults with alcohol dependence engaged in motivational enhancement therapy 2019 Randomized controlled trial n = 40
A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial. Cocaine-dependent adults 2019 Randomized controlled trial n = 55
Single Versus Repeated Sessions of Ketamine-Assisted Psychotherapy for People with Heroin Dependence Detoxified inpatients with heroin dependence 2007 Randomized controlled trial n = 59
Adjunctive Ketamine With Relapse Prevention–Based Psychological Therapy in the Treatment of Alcohol Use Disorder Patients with severe alcohol use disorder 2022 Randomized controlled trial n = 96

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