I completed a first class BSc in Psychology at the University of Exeter and an MSc with distinction in Clinical Mental Health Sciences at University College London. I am currently undertaking a PhD at the University of Exeter funded by the SSA, under the supervision of Professor Celia Morgan and Professor Ed Watkins.
My PhD project aims to understand the role of ruminative thinking in initiating and maintaining alcohol use disorders and to explore rumination as a target of treatment approaches including Rumination Focused Cognitive Behavioural Therapy (CBT) and novel pharmacological treatment with ketamine.
Ketamine for the treatment of substance use disorders: a systematic review
Background: Ketamine is an NMDA receptor antagonist, widely used as an anaesthetic drug. In the last two decades, sub-anaesthetic doses of ketamine have been demonstrated to have rapid and sustained antidepressant effects. Possible mechanisms of ketamine’s antidepressant actions include enhancing synaptic plasticity and synaptogenesis and modulation of functional network connectivity. These mechanisms may also apply to adaptations seen in substance use disorders. In fact, other studies have reported ketamine’s therapeutic effects in the treatment of alcohol and drug use disorders. This review will explore the recent clinical research into ketamine’s effectiveness to treat addiction.
Methods: We conducted a search of Medline (1946 -October 2018), PsychInfo (1806 -October 2018) and ClinicalTrials.gov (up to August 2019) databases to identify human studies investigating the effectiveness of ketamine for substance use disorders.
Results and conclusions: 11 completed studies were identified, with four studies focusing on alcohol use disorder, four on cocaine use disorder and three on opiate use disorder. Ketamine was associated with a significant disruption in cocaine use, lower levels of craving, increased motivation to quit and longer time to relapse. In alcohol and opiate studies, ketamine was associated with higher rates of abstinence, although one opiate study found no difference in abstinence between the ketamine and the control group. The limitations of these studies including small sample sizes, lack of randomisation, blinding and appropriate placebo control group are discussed. There is a clear need for larger randomised, blinded and placebo controlled trials in this topic. Relevant ongoing studies are briefly discussed.