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. 2023 Apr 27:14:1141836.
doi: 10.3389/fpsyt.2023.1141836. eCollection 2023.

The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review

Charlotte E Goldfine  1 , Jeremiah J Tom  1 , Dana D Im  1 , Benjamin Yudkoff  2 , Amit Anand  2 , Joseph J Taylor  2   3 , Peter R Chai  1   4   5 , Joji Suzuki  2
Affiliations

The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review

Charlotte E Goldfine et al. Front Psychiatry. .

Abstract

Introduction: Alcohol use disorder (AUD) is the most prevalent substance use disorder (SUD) globally. In 2019, AUD affected 14.5 million Americans and contributed to 95,000 deaths, with an annual cost exceeding 250 billion dollars. Current treatment options for AUD have moderate therapeutic effects and high relapse rates. Recent investigations have demonstrated the potential efficacy of intravenous ketamine infusions to increase alcohol abstinence and may be a safe adjunct to the existing alcohol withdrawal syndrome (AWS) management strategies.

Methods: We followed Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines to conduct a scoping review of two databases (PubMed and Google Scholar) for peer-reviewed manuscripts describing the use of ketamine in AUD and AWS. Studies that evaluated the use of ketamine in AUD and AWS in humans were included. We excluded studies that examined laboratory animals, described alternative uses of ketamine, or discussed other treatments of AUD and AWS.

Results: We identified 204 research studies in our database search. Of these, 10 articles demonstrated the use of ketamine in AUD or AWS in humans. Seven studies investigated the use of ketamine in AUD and three studies described its use in AWS. Ketamine used in AUD was beneficial in reducing cravings, alcohol consumption and longer abstinence rates when compared to treatment as usual. In AWS, ketamine was used as an adjunct to standard benzodiazepine therapy during severe refractory AWS and at signs of delirium tremens. Adjunctive use of ketamine demonstrated earlier resolution of delirium tremens and AWS, reduced ICU stay, and lowered likelihood of intubation. Oversedation, headache, hypertension, and euphoria were the documented adverse effects after ketamine administration for AUD and AWS.

Conclusion: The use of sub-dissociative doses of ketamine for the treatment of AUD and AWS is promising but more definitive evidence of its efficacy and safety is required before recommending it for broader clinical use.

Keywords: alcohol abstinence; alcohol use disorder; alcohol withdrawal syndrome; clinical trials; ketamine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Identification of studies via databases using the PRISMA (Preferred Reporting Items for Systematic Reviews) flow diagram.
See this image and copyright information in PMC

References

    1. Degenhardt L, Charlson F, Ferrari A, Santomauro D, Erskine H, Mantilla-Herrara A, et al. . The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Psychiatry. (2018) 5:987–1012. doi: 10.1016/S2215-0366(18)30337-7, PMID: - DOI - PMC - PubMed
    1. World Health Organization (WHO) (2018). Global status report on health and alcohol.
    1. SAMHSA, Center for Behavioral Health Statistics and Quality (2019). National Survey on drug use and health. Table 5.4A – alcohol use disorder in past year among persons aged 12 or older, by age group and demographic characteristics: numbers in thousands, 2018 and 2019. Available at: https://www.samhsa.gov/data/sites/default/files/reports/rpt29394/NSDUHD [Accessed December 8, 2020].
    1. Centers for Disease Control and Prevention (CDC). Alcohol and Public Health: Alcohol-Related Disease Impact (ARDI). Annual Average for United States (2011–2015). Alcohol-attributable deaths due to excessive alcohol use, all ages. Available at: https://nccd.cdc.gov/DPH_ARDI/Default/Default.aspx [Accessed December 8, 2020].
    1. Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med. (2011) 41:516–24. doi: 10.1016/J.AMEPRE.2011.06.045, PMID: - DOI - PubMed

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