Therapeutic potential of ketamine for alcohol use disorder.
Stephen D Worrell, Thomas J Gould
Neuroscience and biobehavioral reviews July 1, 2021 Peer reviewed DOI: 10.1016/j.neubiorev.2021.05.006 via PubMed
Summary
Excessive alcohol consumption significantly contributes to U.S. adult deaths and economic costs. Alcohol Use Disorder (AUD) is linked with depression and stress, complicating treatment options. Current medications have limitations, leading to the exploration of ketamine, an NMDA antagonist, which shows promise in treating AUDs due to its effects on neurotransmitter systems and neurogenesis. This review discusses the behavioral and neural evidence supporting ketamine's use for AUDs and related Substance Use Disorders.
Study at a glance
| Design | review |
|---|---|
| Key finding | Ketamine shows promise as a treatment for Alcohol Use Disorder due to its effects on neurotransmitter systems and neurogenesis. |
Abstract
Excessive alcohol consumption is involved in 1/10 of deaths of U.S. working-age adults and costs the country around $250,000,000 yearly. While Alcohol Use Disorder (AUD) pathology is complex and involves multiple neurotransmitter systems, changes in synaptic plasticity, hippocampal neurogenesis, and neural connectivity have been implicated in the behavioral characteristics of AUD. Depressed mood and stress are major determinants of relapse in AUD, and there is significant comorbidity between AUD, depression, and stress disorders, suggesting potential for overlap in their treatments. Disulfiram, naltrexone, and acamprosate are current pharmacotherapies for AUD, but these treatments have limitations, highlighting the need for novel therapeutics. Ketamine is a N-methyl-D-Aspartate receptor antagonist, historically used in anesthesia, but also affects other neurotransmitters systems, synaptic plasticity, neurogenesis, and neural connectivity. Currently under investigation for treating AUDs and other Substance Use Disorders (SUDs), ketamine has strong support for efficacy in treating clinical depression, recently receiving FDA approval. Ketamine's effect in treating depression and stress disorders, such as PTSD, and preliminary evidence for treating SUDs further suggests a role for treating AUDs. This review explores the behavioral and neural evidence for treating AUDs with ketamine and clinical data on ketamine therapy for AUDs and SUDs.