Ketamine for substance use disorders: a systematic review and meta-analysis
Shu-Ping Fang, Xin Yang, Da-Cong Zhao, Wen Yang, Ying Liu, Zhe Li, Mao-Sheng Ran
Frontiers in Psychiatry July 17, 2026 DOI: 10.3389/fpsyt.2026.1835709 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 798 |
| Population | Participants with substance use disorder (SUD) |
| Intervention | Ketamine |
| Topics | Ketamine Addiction Esketamine |
| Keywords | Abstinence Adverse effect Randomized controlled trial Clinical trial Medline Substance abuse Meta-analysis Dropout neural networks Anesthesia |
| Key findings | Ketamine significantly improved short-term abstinence (less than one month) but not longer-term abstinence (one to six months) in substance use disorder. |
Abstract
Introduction: Substance use disorder (SUD) is a major global health issue, contributing significantly to the disease burden. Despite this, effective treatments for SUD remain limited. Ketamine has shown potential as a treatment, yet no meta-analysis has assessed its efficacy for SUD. This study aimed to evaluate the efficacy and safety of ketamine in treating SUD.
Methods: Multiple databases were systematically searched forrandomized controlled trials (RCTs) on ketamine for SUD treatment. The primary outcome was abstinence rates. Adverse events and dropout rates were also assessed to evaluate safety and acceptability. A random-effects model was used to conduct the meta-analysis.
Results: Fifteen RCTs with 798 participants were included; seven RCTs contributed abstinence data to the quantitative synthesis. Ketamine was associated with significantly improved abstinence at <1 month [odds ratio(OR) = 3.27, 95% CI: 1.55–6.92, I 2 = 0%, p < 0.01], but not at 1–6 months (OR = 1.74, 95% CI: 0.91–3.30, I 2 = 0%, p = 0.09). No significant difference in dropout rates was observed between the ketamine and control groups (OR = 0.74, 95% CI: 0.46–1.21, I 2 = 0%, p = 0.23). No significant between group difference was identified in adverse events, although the available evidence was limited and insufficient to establish safety conclusively.
Discussion: Current evidence suggests a short-term efficacy signal for ketamine in SUD, but the evidence remains limited and insufficient to establish its efficacy and safety conclusively. Systematic review registration identifier CRD42024607116.
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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Ketamine significantly improved short-term abstinence (under one month, OR=3.27) but not longer-term abstinence (one to six months, OR=1.74, not significant), with no significant difference in dropout or adverse events.
Synthesized
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 |
| Ketamine Treatment for Alcohol Use Disorder: A Systematic Review. Adult patients with alcohol use disorder, heavy drinkers, or those undergoing alcohol... | 2023 | Systematic review | n = 854 |