Cited by 143Substance Abuse Treatment and OutcomesTreatment of Major DepressionNeurotransmitter Receptor Influence on Behavior

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The Effects of Subanesthetic Ketamine Infusions on Motivation to Quit and Cue-Induced Craving in Cocaine-Dependent Research Volunteers

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Dakwar, Elias, Levin, Frances, Foltin, Richard W., Nunes, Edward V., Hart, Carl L.·2014·Biological Psychiatry

DOI 10.1016/j.biopsych.2013.08.009PMC PMC4105157

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Abstract

Background Cocaine dependence involves problematic neuroadaptations that might be responsive to modulation of glutamatergic circuits. This investigation examined the effects of subanesthetic ketamine infusions on motivation for quitting cocaine and on cue-induced craving in cocaine-dependent participants, 24 hours postinfusion.Methods Eight volunteers with active DSM-IV cocaine dependence not seeking treatment or abstinence were entered into this crossover, double-blind trial. Three 52-min intravenous infusions were administered: ketamine (.41 mg/kg or .71 mg/kg) or lorazepam 2 mg, counterbalanced into three orderings in which ketamine .41 mg/kg always preceded the .71 mg/kg dose. Infusions were separated by 48 hours, and assessments occurred at baseline and at 24 hours postinfusion. Outcomes were change between postinfusion and preinfusion values for: 1) motivation to quit cocaine scores with the University of Rhode Island Change Assessment; and 2) sums of visual analogue scale craving ratings administered during cue exposure.Results Compared with the active control lorazepam, a single ketamine infusion (.41 mg/kg) led to a mean 3.9-point gain in University of Rhode Island Change Assessment (p = .012), which corresponds to an approximately 60% increase over preceding values. There was a reduction of comparable magnitude in cue-induced craving (p = .012). A subsequent ketamine infusion (.71 mg/kg) led to further reductions in cue-induced craving compared with the control. Infusions were well-tolerated.Conclusions Subanesthetic ketamine demonstrated promising effects on motivation to quit cocaine and on cue-induced craving, 24 hours postinfusion. Research is needed to expand on these preliminary results and to evaluate the efficacy of this intervention in clinical settings.

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Authors: Dakwar, E., Levin, F., Foltin, R. W., Nunes, E. V., & Hart, C. L.
Affiliations: New York State Psychiatric Institute (US)
Corresponding author: Dakwar, Elias
ORCID: Levin, Frances
Foltin, Richard W.
Nunes, Edward V.
Hart, Carl L.
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2014-07
Volume: 76
Issue: 1
Pages: 40-46
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2013.08.009
PMC: PMC4105157
OpenAlex: W2056114002
Cited by: 143
References: 41
Citations by year: 2026: 11 · 2025: 22 · 2024: 18 · 2023: 12 · 2022: 18 · 2021: 9 · 2020: 8 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 13 · 2015: 4 · 2014: 4
FWCI: 5.11
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Drug Abuse (DA031749-02, DA031771-01, K05DA031749, DA007294-19, DA029647-02, DA031749-01, P50DA009236, DA009236-18, R01DA003476, DA03476-23, K24DA029647, K23DA031771, T32DA007294)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords: subanesthetic ketamine, cocaine dependence, motivation to quit, cue-induced craving, glutamatergic circuits, neural adaptation, University of Rhode Island Change Assessment
MeSH terms: Adult, Cues, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hypnotics and Sedatives, Infusions, Intravenous, Ketamine, Lorazepam, Male, Middle Aged, Motivation, Behavior, Addictive, Cross-Over Studies, Excitatory Amino Acid Antagonists, Cocaine-Related Disorders, Young Adult, Craving

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The Effects of Subanesthetic Ketamine Infusions on Motivation to Quit and Cue-Induced Craving in Cocaine-Dependent Research Volunteers

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