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Cited by 123Psychedelics and Drug StudiesTreatment of Major DepressionSubstance Abuse Treatment and Outcomes

Therapeutic infusions of ketamine: do the psychoactive effects matter?

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Dakwar, E., Anerella, C., Hart, C.L., Levin, F.R., Mathew, S.J., Nunes, E.V.·2014·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2013.12.019PMC PMC4091719
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Abstract

Background Sub-anesthetic ketamine infusions may benefit a variety of psychiatric disorders, including addiction. Though ketamine engenders transient alterations in consciousness, it is not known whether these alterations influence efficacy. This analysis evaluates the mystical-type effects of ketamine, which may have therapeutic potential according to prior research, and assesses whether these effects mediate improvements in dependence-related deficits, 24h postinfusion.Methods Eight cocaine dependent individuals completed this double-blind, randomized, inpatient study. Three counter-balanced infusions separated by 48h were received: lorazepam (2mg) and two doses of ketamine (0.41mg/kg and 0.71mg/kg, with the former dose always preceding the latter). Infusions were followed within 15min by measures of dissociation (Clinician Administered Dissociative Symptoms Scale: CADSS) and mystical-type effects (adapted from Hood's Mysticism Scale: HMS). At baseline and 24h postinfusion, participants underwent assessments of motivation to stop cocaine (University of Rhode Island Change Assessment) and cue-induced craving (by visual analogue scale for cocaine craving during cue exposure).Results Ketamine led to significantly greater acute mystical-type effects (by HMS) relative to the active control lorazepam; ketamine 0.71mg/kg was associated with significantly higher HMS scores than was the 0.41mg/kg dose. HMS score, but not CADSS score, was found to mediate the effect of ketamine on motivation to quit cocaine 24h postinfusion.Conclusions These findings suggest that psychological mechanisms may be involved in some of the anti-addiction benefits resulting from ketamine. Future research can evaluate whether the psychoactive effects of ketamine influence improvements in larger samples.

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  • Many patients describe psychedelic-induced peak or mystical experiences as being among the most meaningful events of their lives, and the intensity of these events correlates with therapeutic responses.

    “Many patients describe psychedelic-induced “peak” or “mystical” experiences as being among the most meaningful events of their lives, and the intensity of these events correlates with therapeutic responses (40, 220–226).”

    From Psychedelics and Other Psychoplastogens for Treating Mental Illness. (2021) · cites this paper as [226]

    The Introduction describes psychedelic experiences as having enduring personal importance, but does not say that many patients rank them among the most meaningful events of their lives. The Discussion reports that the intensity of ketamine-induced mystical-type effects was associated with motivation to quit cocaine at 24 hours, but not with improvement in cue-induced craving. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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  • Embedding ketamine administration into a mindfulness-enhancing behavioural training framework successfully extended ketamine's anti-addictive properties, which had previously been reported only transiently.

    “This study demonstrated that embedding ketamine administration into a mindfulness-enhancing behavioural training framework successfully extended ketamine's anti-addictive properties, which had previously been reported only transiently, subsiding over several days (138, 139).”

    From Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy (2021) · cites this paper as [138]

    The Results report an improvement in motivation to quit cocaine 24 hours after ketamine infusion. But the Discussion proposes evaluating a framework to enhance and consolidate ketamine’s psychological benefits as future research; this study did not test mindfulness-enhancing behavioural training or show that it extended anti-addictive effects. The Introduction’s statement that benefits generally subside by 72 hours concerns depressive symptoms, not addiction. Page numbers are unavailable in our copy. (LLM, conf=0.86)

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Authors
Dakwar, E., Anerella, C., Hart, C. L., Levin, F. R., Mathew, S. J., & Nunes, E. V.
Affiliations
  • New York State Psychiatric Institute (US)
  • Michael E. DeBakey VA Medical Center (US)
Corresponding author
Dakwar, E.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2014-03
Volume
136
Pages
153-157
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2013.12.019
PMC
PMC4091719
OpenAlex
W2078153416
Cited by
123
References
34
Citations by year
2026: 10 · 2025: 9 · 2024: 24 · 2023: 11 · 2022: 14 · 2021: 11 · 2020: 9 · 2019: 7 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 5
FWCI
8.65
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health (R01MH081870, MH081870)
  • National Institute on Drug Abuse (K24DA022412, R21DA035472, DA022412, P50DA009236, DA031771, DA009236, K24DA029647, DA007294, DA035472, K23DA031771, T32DA007294)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
ketamine, cocaine dependence, dissociation, psychoactive effects, cue-induced craving, lorazepam, addiction treatment, dose-response relationship
MeSH terms
Adult, Anesthetics, Dissociative, Cues, Data Interpretation, Statistical, Dissociative Disorders, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hypnotics and Sedatives, Infusions, Intravenous, Inpatients, Ketamine, Lorazepam, Male, Motivation, Mysticism, Crack Cocaine, Cocaine-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders

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