Ketamine and therapy may help treat alcoholism, researchers say

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Beating alcoholism is notoriously difficult, but researchers are hoping a new combination of treatments might help: ketamine and psychological therapy.

The use of psychedelics alongside therapy is a burgeoning area of ​​research, with ketamine, MDMA and psilocybin – the active ingredient in magic mushrooms – among drugs being studied to combat mental health issues ranging from depression to PTSD.

Researchers are now set to launch a £2.4million phase 3 trial, the largest of its kind, to explore the use of ketamine in the treatment of severe alcohol use disorder .

Professor Celia Morgan from the University of Exeter, who is leading the new trial, said people with alcohol problems might find it difficult to engage in psychological interventions, but ketamine might help.

“Our model really uses ketamine as a catalyst for therapy,” she said.

The team behind the study, known as Ketamine for Alcohol Relapse Reduction (Kare), previously performed a proof-of-concept trial which suggested that people with severe of alcohol use who received ketamine alongside psychological therapy were more likely to remain completely abstinent six months later. than those who received a placebo.

Related: “Ketamine Blown Me Away”: Can Psychedelics Cure Addiction and Depression?

“This phase 3 trial aims to find definitive evidence of this effect so that we can eventually roll out this treatment to patients and the NHS,” Morgan said.

While other scientists have also sought to address alcohol problems with ketamine-based treatment, Morgan noted that some of these studies have focused on social drinkers and used a one-time behavioral disruption intervention. memory.

By contrast, the new trial will take place at seven NHS sites across the UK and is expected to involve 280 participants with severe alcohol use disorders – the group, Morgan noted, that is the hardest to treat. and most likely to relapse.

With previous work showing that ketamine enhances the effect of psychological therapy, participants will be divided into two groups.

Half of the participants will receive three separate infusions of a very low dose of ketamine, 0.01 mg/kg, over a period of one to two months, with educational sessions on relaxation and the harmful effects of alcohol administered before and after each dose, with a seventh educational session at the end of the intervention period.

Morgan said the very low dose shouldn’t have therapeutic effects, but it would help participants not know which of the two study groups they were in, helping the team control for placebo effects. .

The other group of participants will receive three infusions of a much higher dose of ketamine, 0.8 mg/kg, as well as seven sessions of psychological therapy. This level of ketamine, Morgan said, was comparable to a high recreational dose.

“In our proof-of-concept study, people were going through some pretty unusual things like having out-of-body experiences, feeling like they had these ideas and epiphanies in their lives,” she said.

Morgan said such experiments could be useful in helping participants change their perspective and see their alcohol problems in a different way, while ketamine also promoted the growth of new synapses in the brain – an effect that would peak 24 hours after taking the drug.

“We time one of our psychological therapies so that the brain is really ready for new learning,” she said.

Both groups of participants will be followed at three and six months, with their alcohol consumption measured via a combination of self-reported smartphone-mounted breathalyzers and wearable devices.

“We are looking for significant differences in abstinence at six months,” Morgan said.

Morgan stressed that the drug alone was not meant to help people with alcohol problems, adding that the trial would be conducted under safe and carefully controlled conditions alongside therapy.

Mitul Mehta, professor of neuroimaging and psychopharmacology at King’s College London, who is not involved in the research, welcomed the trial.

“The earlier trial warrants this broader investigation. We also need a boost to better understand the mechanisms of treatment effect so that patients most likely to respond can be selected and followed up appropriately,” he said. “By carefully examining the mechanisms, we can also learn more about the most effective ways to refine treatment in the future.”

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