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35th AM (2025) - Poster Session
Ketamine for the Treatment of Alcohol Use Disorder ...
Ketamine for the Treatment of Alcohol Use Disorder A Call to Action for Future Clinical Practice Guidelines
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Pdf Summary
This narrative review by Lee and Wolfgang highlights the emerging use of ketamine as a potential treatment for alcohol use disorder (AUD), a prevalent condition affecting over 10% of the U.S. population, including higher rates among veterans. Despite existing FDA-approved medications such as naltrexone, disulfiram, and acamprosate, relapse rates remain high, indicating a need for novel therapeutic options.<br /><br />The authors conducted a literature search focusing on clinical trials and reviews from the past five years (2020-2025) examining ketamine's efficacy in AUD treatment. They identified promising findings from four randomized clinical trials and additional cohort studies and case series. Key results include:<br /><br />- Grabski et al. (2022): Ketamine combined with mindfulness-based relapse prevention therapy resulted in 65.8% abstinent days versus 27% with placebo.<br />- Dakwar et al. (2020): A single ketamine infusion plus motivational enhancement therapy lowered alcohol use to 47.1% compared to 59.1% with midazolam control.<br />- Das et al. (2019): Ketamine administered alongside maladaptive memory retrieval protocols significantly reduced craving and drinking at multiple follow-up points.<br />- Krupitsky et al. (1992): Ketamine plus psychotherapy yielded a one-year abstinence rate of 65.8%, markedly higher than controls.<br /><br />Despite these encouraging data, current major clinical practice guidelines (VA/DoD, APA, NICE) do not yet include ketamine as a recommended treatment for AUD. The review calls for future guidelines to incorporate ketamine based on accumulating evidence, acknowledging its off-label use for treatment-resistant depression and suicidality as a precedent.<br /><br />In conclusion, ketamine shows promise as an adjunctive treatment for alcohol use disorder, potentially improving abstinence and reducing relapse. However, its integration into standard practice awaits further evaluation and guideline endorsement. The authors advocate for more rigorous trials and updates to clinical recommendations to reflect these advances, aiming to improve long-term outcomes for individuals with AUD.
Keywords
ketamine
alcohol use disorder
AUD
treatment
clinical trials
relapse prevention
mindfulness-based relapse prevention therapy
psychotherapy
FDA-approved medications
clinical practice guidelines
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