Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems
In a double-blind, randomised pilot study of 28 people with alcohol problems, sublingual esketamine (115.1 mg) combined with two weeks of daily mindfulness-based intervention increased psychological engagement with the practice and produced transient reductions in alcohol craving versus placebo. Esketamine also elicited greater mystical and dissociative experiences, suggesting these altered states may underlie enhanced engagement and potential therapeutic benefit.
Authors
- Celia Morgan
Published
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.
Research Summary of 'Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems'
Introduction
Alcohol misuse is described as a leading global health problem with high relapse rates despite available pharmacological and behavioural treatments; only 18% of alcohol-dependent drinkers receive treatment in the UK and those who do are reported to be 70%-80% likely to relapse within the first year. Ketamine, and specifically esketamine (the S-enantiomer), has emerged in addiction research as a promising adjunctive treatment: prior studies have reported reductions in alcohol craving and consumption and improved abstinence when ketamine is combined with psychotherapy, but the mechanisms behind these benefits remain unclear. Gent and colleagues set out to test one proposed mechanism — that esketamine enhances engagement in psychotherapy — by combining a single dose of sublingual esketamine with a brief mindfulness-based intervention (MBI) in hazardous drinkers. The primary aim was to determine whether esketamine increases psychological and/or physical engagement with daily mindfulness practice and whether any increase in engagement mediates improvements in alcohol-related outcomes such as craving and consumption. The authors hypothesised that esketamine would enhance engagement in MBI and that this enhancement would be associated with better drinking-related outcomes.
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Study Details
- Study Typeindividual
- Journal
- Compounds
- Topics
- Author
- APA Citation
Gent, E. M., Bryan, J. W., Cleary, M. A., Clarke, T. I., Holmwood, H. D., Nassereddine, R. O., Salway, C., Depla, S., Statton, S., Krecké, J., & Morgan, C. J. (2024). Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems. Journal of Psychopharmacology, 38(6), 541-550. https://doi.org/10.1177/02698811241254834
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