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

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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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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: Hart, C.L.
Levin, F.R.
Mathew, S.J.
Nunes, E.V.
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: green
www.ncbi.nlm.nih.gov
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 (medical) › 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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