A Single Ketamine Infusion Combined With Mindfulness-Based Behavioral Modification to Treat Cocaine Dependence: A Randomized Clinical Trial
Am J Psychiatry 2019; 176:923–930; doi: 10.1176/appi.ajp.2019.18101123
Elias Dakwar, M.D., Edward V. Nunes, M.D., Carl L. Hart, Ph.D., Richard W. Foltin, Ph.D., Sanjay J. Mathew, M.D.,
Kenneth M. Carpenter, Ph.D., C.J. “Jean” Choi, M.S., Cale N. Basaraba, M.P.H., Martina Pavlicova, Ph.D., Frances R. Levin, M.D.
A study recently published in the American Journal of Psychiatry found that Ketamine, an NMDA blocker that promotes synaptogenesis, plus Mindfulness Therapy effectively treated cocaine dependent patients. Fifty five cocaine dependent subjects were treated with either ketamine or midazolam combined with mindfulness behavior therapy. The study found that ketamine was significantly more effective in treating cocaine cravings and was associated with a significantly higher rate of abstinence than patients treated with midazolam, a medication used as a control. Craving scores were 58.1 % lower in the Ketamine group than the control group. At six month follow up, 44% of patients treated with Ketamine were abstinent compared with 0% of patients in the control group. The authors found that ketamine infusions given at a dose of 0.5mg/kg over 40 minutes was well tolerated, and promoted abstinence in cocaine addicted patients. Ketamine was associates with a lower likelihood of cocaine use, lower levels of cocaine craving and longer time to relapse. This study represents a promising treatment modality for cocaine addiction, an illness for which, until now, has had no effective treatments.