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.
Nicolas Garel, Christina Mcanulty, Kyle T. Greenway, Paul Lespérance, Jean-Philippe Miron, Soham Rej, Stephane Richard-Devantoy, Didier Jutras-Aswad
Drug and Alcohol Dependence August 19, 2022 DOI: 10.1016/j.drugalcdep.2022.109606 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 634 |
| Population | People with harmful alcohol use, alcohol craving, or alcohol withdrawal states, including outpatients and patients admitted to intensive care for severe alcohol withdrawal |
| Intervention | Ketamine |
| Topics | Addiction Esketamine Ketamine |
| Citations | 33 |
| Key findings | Across 8 studies and 634 participants, results on primary outcomes were mixed within and across trials. The authors conclude that despite promising results, the evidence does not permit definitive conclusions about ketamine's efficacy for alcohol use disorder or withdrawal, and they call for further research. |
Abstract
Background: Alcohol use disorder is highly prevalent and has important economical, societal, psychiatric, and medical consequences. All currently approved therapeutic approaches targeting alcohol dependence have relatively modest effects and high relapse rates. Recent evidence suggests that ketamine may be an effective intervention to treat alcohol use disorder and alcoholic withdrawal. This systematic review aimed to assess the current level of evidence for this intervention.
Methods: This systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered on the international database of systematic reviews PROSPERO. Medline(Ovid), CINAHL Complete(EBSCOhost), PsycINFO(Ovid), EBM Reviews(Ovid), EMBASE(Ovid), and Google Scholar were searched for studies using ketamine to treat harmful alcohol use, craving, or withdrawal states in humans. Studies of any methodology that evaluated ketamine in isolation or combination with other interventions were included. The risk of bias was assessed using specific Cochrane critical appraisal tools.
Results: Of 1922 abstracts identified, 8 full-text articles were eligible for inclusion, yielding a total sample size of 634 participants. Five studies investigated the impact of ketamine on alcohol use and/or cravings and/or withdrawal in outpatient settings. Three studies looked at the effect of adding ketamine to conventional treatment of withdrawal symptoms in participants admitted to intensive care unit for severe alcohol withdrawal. Results on primary outcomes were mixed within and across trials.
Conclusions: Despite promising results, the current evidence does not permit definitive conclusions about the efficacy of ketamine in alcohol use disorders or withdrawal. Future studies are warranted.
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 | |
| 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 |
| 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
Cited by 22
- The Montreal model: an integrative biomedical-psychedelic approach to ketamine for severe treatment-resistant depression Frontiers in Psychiatry September 19, 2023
- The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review Frontiers in Psychiatry April 27, 2023
- Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings Frontiers in Human Neuroscience July 18, 2023
- Is there a risk of addiction to ketamine during the treatment of depression? A systematic review of available literature. Journal of Psychopharmacology 2025
- Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems. Journal of Psychopharmacology June 1, 2024
and 17 more in the library
Cites 23
- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Science August 19, 2010
- Synaptic Dysfunction in Depression: Potential Therapeutic Targets Science October 4, 2012
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Ketamine use: a review Addiction July 21, 2011
- Blinding and expectancy confounds in psychedelic randomized controlled trials Expert Review of Clinical Pharmacology May 26, 2021
and 18 more in the library