Researcher Nicola Davis Science Correspondent: Ketamine combined with therapy may be used to treat alcoholism.
Researchers are hopeful that a new treatment approach combining ketamine and psychological therapy may be helpful in treating the notoriously difficult condition of alcoholism.
Ketamine, MDMA, and psilocybin, the primary ingredient in magic mushrooms, are just a few of the psychedelics being researched for usage in conjunction with therapy to treat conditions ranging from PTSD to depression.
The largest study of its kind, a £2.4 million phase 3 trial, is about to begin and will examine the use of ketamine in the treatment of severe alcohol use disorder.
People with alcohol problems may find it challenging to engage with psychological interventions, but ketamine may be able to help, according to Prof. Celia Morgan of the University of Exeter, who is directing the new experiment.
Our strategy truly uses ketamine as a trigger for the treatment, she explained.
The researchers behind the study, known as Ketamine for Reduction of Alcohol Relapse (Kare), have already completed a proof-of-concept study that found those with severe alcohol use disorders who received ketamine along with psychological therapy were more likely to remain abstinent completely six months later than those who received a placebo.
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In order to finally offer this treatment to patients and the NHS, Morgan stated, "our phase 3 trial hopes to discover conclusive evidence of this effect."
However, Morgan pointed out that some of those studies had focused on social drinkers and used a one-off memory disruption intervention. Other researchers have also looked at treating alcohol problems with a ketamine-based therapy.
The current research, in contrast, will take place at seven NHS locations in the UK and is anticipated to include 280 people with severe alcohol use disorder—the group that Morgan said is the most challenging to treat and the most susceptible to relapse.
The subjects will be divided into two groups since prior research has shown that ketamine enhances the effects of psychological therapy.
Over the course of one to two months, half of the participants will receive three separate infusions of a very low dose of ketamine, 0.01 mg/kg. Before and after each infusion, there will be educational sessions about relaxation and the negative effects of alcohol, and there will be one final session at the conclusion of the intervention.
The extremely low amount, according to Morgan, was not anticipated to have any therapeutic effects but would help to prevent participants from knowing which of the two study groups they were in, aiding the team in minimizing the impact of placebo effects.
The second group of volunteers will receive seven sessions of psychological counseling in addition to three infusions of 0.8 mg/kg of ketamine, which is a substantially higher dose. Morgan claimed that the amount of ketamine present was comparable to a sizable recreational dose.
According to her, "in our proof of concept study, people were having some fairly peculiar experiences, such as having out of body experiences, feeling as though they were getting these insights and epiphanies into their lives."
While ketamine also increased the creation of new synapses in the brain, an effect anticipated to peak 24 hours after taking the drug, Morgan said such experiences could be helpful in helping individuals change their perspective and perceive their drinking problems in a different way.
She explained, "We schedule one of our psychological therapies so that the brain is particularly prepared for new learning.
At three and six months, both participant groups will be checked in on, and their alcohol use will be assessed using a combination of wearables, smartphone-mounted breathalyzers, and self-report.
At six months, "we are looking for major changes in abstinence," Morgan added.
Morgan emphasized that the medicine was not thought to be effective in treating alcoholism on its own and that the trial would be conducted in conjunction with therapy under safe, meticulously controlled conditions.
The trial was well-received by Mitul Mehta, a King's College London professor of neuroimaging and psychopharmacology who is not engaged in the study.
"This thorough examination is justified by the earlier trial. To choose and properly monitor patients who are most likely to respond, it is also necessary to push for a greater understanding of the mechanisms underlying the treatment's effects, the expert added. The most efficient strategies to improve treatment in the future can also be discovered by carefully researching the mechanisms.
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