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A proof-of-concept investigation into ketamine as a pharmacological treatment for alcohol dependence: study protocol for a randomised controlled trial

Amy Mcandrew, Will Lawn, Tobias Stevens, Lilla Alexandra Porffy, Brigitta Brandner, Celia J. A. Morgan

Trials April 4, 2017 DOI: 10.1186/s13063-017-1895-6 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Placebo-controlled Double-blind Peer reviewed
Sample size 96
Population Recently detoxified adults with alcohol dependence and comorbid depressive symptoms
Interventions Ketamine psychological therapy alcohol education control
Dose 0.8 mg/kg administered intravenously over 40 minutes; placebo 50 ml saline 0.9% IV over 40 minutes
Duration Three treatment sessions; assessments at 3 and 6 months
Topics Addiction Esketamine Ketamine
Citations 20
Registration NCT02649231
Key findings The protocol proposes that combining repeated ketamine infusions with manualised psychological therapy may reduce relapse in severe alcohol use disorder, and describes a four-arm randomized trial designed to test this against placebo and an alcohol education control. No outcome data are reported; the authors state the trial will assess relapse rates and percentage days abstinent at six months.

Abstract

Background: Worldwide, alcohol abuse is a burgeoning problem. Abstinence is key to allow recovery of physical and mental health as well as quality of life, but treatment for alcohol dependence is associated with high relapse rates. Preliminary data have suggested that a combined repeated ketamine and psychological therapy programme may be effective in reducing relapse in severe alcohol use disorder. This non-commercial proof-of-concept trial is aimed at making a preliminary assessment of the effectiveness of this combined treatment in this patient group. METHODS/DESIGN: This is a phase II, randomised, double-blind, placebo-controlled, parallel-group clinical trial taking place in two sites in the UK: the South West of England and London. Ninety-six recently detoxified alcoholics, with comorbid depressive symptoms, will be randomised to one of four treatment arms. Patients will receive either three sessions of ketamine (0.8 mg/kg administered intravenously (IV) over 40 minutes) or placebo (50 ml saline 0.9% IV over 40 minutes) plus either seven sessions of manualised psychological therapy or an alcohol education control. Patients will be assessed at 3 and 6 months on a range of psychological and biological variables. The primary endpoints are (1) relapse rates at 6 months and (2) percentage days abstinent at 6 months. Secondary endpoints include 3 and 6 month percentage days abstinence, tolerability (indicated by dropout), adverse events, depressive symptoms, craving and quality of life.

Discussion: This study will provide important information on a new combined psychological and pharmacological intervention aimed at reducing relapse rates in alcoholics. The findings would have broad application given the worldwide prevalence of alcoholism and its associated medical, psychological and social problems.

Trial Registration: ClinicalTrials.gov, NCT02649231 . Registered on 5 January 2016.

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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