New research suggests that ketamine may help people struggling with alcohol addiction. The small randomised, controlled trial found that people with severe alcohol use disorder given infusions of ketamine reported more days of abstinence at a six-month follow-up than those in a control group. The benefits also appeared to be greater for people given ketamine in addition to psychotherapy.
Ketamine has long been used as a sedative for both people and animals, and is sometimes taken as a recreational drug with hallucinogenic effects. In recent years, it’s taken on another identity as a depression treatment. Since 2019, the Food and Drug Administration has approved a modified version of ketamine, available as a nasal spray, for treatment-resistant depression and for severe depression coupled with acute suicidal ideation, in combination with an oral antidepressant.
Some scientists have been hopeful that ketamine might also help people with alcohol use disorder, based on some early studies. But this new research, published Tuesday in the American Journal of Psychiatry, is purportedly the first clinical trial of its kind.
Researchers at the University of Exeter in the United Kingdom recruited 96 people diagnosed with severe alcohol use disorder. The volunteers were split into four groups, with two groups receiving psychological therapy and two attending alcohol education sessions. Within these pairs, one group would get three weekly infusions of ketamine, and the other a placebo saline solution. Three months and six months after the first infusion, the volunteers would self-report their days spent abstaining from alcohol and if they had relapsed, defined as one or more days of drinking heavily.
There was no major difference in the relapse rate between the ketamine and placebo groups. But those who received ketamine in either condition reported a greater percentage of days spent abstaining from alcohol at both the three- and six-month mark. The largest gap was seen between the group who had gotten ketamine and therapy and the group who had received a placebo and no therapy, with the former reporting sobriety for 162 of 180 days. Those who took ketamine also appeared to have fewer symptoms of depression at three months and better liver function than the placebo groups. There were no serious adverse events reported, though two volunteers did withdraw from the ketamine arm of the trial because they couldn’t tolerate the drug.
“Alcoholism can destroy lives, and we urgently need new ways to help people cut down. We found that controlled, low doses of ketamine combined with psychological therapy can help people stay off alcohol for longer than placebo,” said lead author Celia Morgan in a statement from the university. “This is extremely encouraging, as we normally see three out of every four people returning to heavy drinking within six months of quitting alcohol, so this result represents a great improvement.”
The findings are based on a small sample size, and the research is only intended to be a proof of concept. So it will take more evidence to determine whether ketamine can be effective for alcohol use disorder. Morgan and her team also believe that ketamine alone isn’t likely to be an effective treatment for these individuals. Ideally, it should be paired with therapy or counseling support and only used as a short-term aid. But given the lack of other reliable effective options, and the growing rise of excessive or harmful alcohol use (perhaps in part due to the pandemic), the researchers do hope that ketamine can continue to show promise and eventually become part of the treatment toolbox.
“This was a phase II clinical trial, meaning it’s conducted in people primarily to test the safety and feasibility of the treatment. We now have an early signal this treatment is effective. We now need a bigger trial to see if we can confirm these effects,” said Morgan.