A new study published in the journal JAMA Psychiatry has reported that the combination of naltrexone and ketamine can help treat both symptoms of addiction and depression.
Substance abuse and depression are common in many patients, and efforts to treat both conditions simultaneously have had limited success. One recent study suggested that the antidepressant effects of ketamine might get reduced by administration of naltrexone, used to limit cravings of those addicted to opioid drugs and alcohol.
Ketamine has a rapid onset of action in depression. However, there are concerns about the abuse liability of ketamine. This concern was heightened recently owing to a preliminary report suggesting that antidepressant effects of ketamine might be dependent on opiate receptor stimulation.
A preliminary study of five patients suffering from both depression and substance abuse disorders suggested that it may not be so.
“The results “raise the possibility that for people who have depression complicated by substance abuse disorders, the combination of ketamine and naltrexone may be a strategy to explore in the effort to optimally treat both conditions,” said senior author John Krystal.
The researchers from Yale University treated the five patients suffering from depression and alcohol use disorder with a long-lasting form of naltrexone and then administered ketamine. Four of the five responded to the first ketamine dose and all five found relief from depression after multiple doses.
The study also challenges the idea that ketamine might produce antidepressant effects by stimulating opiate receptors.
The researchers warranted the need for larger studies to confirm the beneficial effects of the combination treatment.
The study concluded that the combination of opiate receptor antagonism with ketamine might be a strategy to reduce addiction risk among patients with depression at risk for substance abuse.
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