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The Effects of Subanesthetic Ketamine Infusions on Motivation to Quit and Cue-Induced Craving in Cocaine-Dependent Research Volunteers
Open accessAbstract
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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“and that cravings were further decreased with a subsequent ketamine infusion (0.71 mg/kg) [147]”
From Ketamine in neuropsychiatric disorders: an update (2024) · cites this paper as [147]
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“a small, randomized, controlled trial (n = 8) found that an initial dose (0.41 mg/kg) of ketamine reduced cue-induced craving at 24 h post-infusion”
From Ketamine in neuropsychiatric disorders: an update (2024) · cites this paper as [147]
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Metadata
- 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
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 76
- Issue
- 1
- Pages
- 40-46
- ISSN
- 0006-3223 (ISSN-L)
- 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
- 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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