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Randomized Controlled Trial
. 2024 Jun;38(6):541-550.
doi: 10.1177/02698811241254834. Epub 2024 Jun 11.

Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems

Emily M Gent  1 , Joshua W Bryan  1 , Maisy A Cleary  1 , Tegan I Clarke  1 , Harry D Holmwood  1 , Rania O Nassereddine  1 , Chris Salway  1 , Simon Depla  1 , Sarah Statton  1 , Joy Krecké  1 , Celia Ja Morgan  1
Affiliations
Randomized Controlled Trial

Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems

Emily M Gent et al. J Psychopharmacol. 2024 Jun.

Abstract

Background: Alcohol use disorder (AUD) is a major public health issue, posing harmful consequences for individuals and society. Recent advances in addiction research have highlighted the therapeutic potential of ketamine-assisted therapy for AUD. However, the exact mechanisms underlying its effectiveness remain unknown.

Aims: This double-blind, pilot study aimed to investigate esketamine combined with mindfulness-based intervention (MBI) to examine whether esketamine enhances engagement in MBI for individuals with alcohol misuse problems and whether enhanced engagement has any impact on alcohol-related outcomes.

Methods: In all, 28 individuals with alcohol problems were randomly assigned to receive sublingual esketamine hydrochloride (AWKN002: 115.1 mg) or vitamin C (placebo) in an oral thin film and took part in 2 weeks of daily MBI. Participants were assessed on various self-report measures, including mindfulness, engagement in MBI (physical and psychological), alcohol cravings and consumption.

Results: Esketamine enhanced psychological engagement with a daily MBI, compared to placebo, and led to transient decreases in alcohol cravings. Esketamine also resulted in significantly greater mystical experiences and dissociative states compared to placebo.

Conclusions: The findings suggest that esketamine may improve treatment outcomes when combined with mindfulness-based therapies through its ability to increase engagement with meditative practice.

Keywords: Esketamine; alcohol use disorder; engagement; ketamine-assisted therapy; mindfulness; mindfulness-based intervention.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Celia JA Morgan has received contract research funds from Awakn Life Sciences and has been seconded to their organisation. The other authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Overview of procedure and study timeline depicting measures taken at each study visit.
Figure 2.
Figure 2.
Study flow diagram portraying participants who were recruited, excluded and enrolled in the study.
Figure 3.
Figure 3.
Changes in psychological engagement in mindfulness-based interventions across time. Error bars represent the standard error of the mean.
Figure 4.
Figure 4.
The impact of esketamine on mean alcohol craving score across four time points, baseline (day 1), pre and post-esketamine administration on day 7, and day 14 of the mindfulness practice. Error bars represent the standard error of the mean.
See this image and copyright information in PMC

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