A pilot study of ketamine among individuals with tobacco use disorder: tolerability and initial impact on tobacco use outcomes.

Objectives: There is increasing evidence of ketamine's therapeutic potential in reducing substance use in individuals with substance use disorders. However, its effects on tobacco use disorder are unknown. We investigated the effect of a subanesthetic dose of ketamine on tobacco use.

Methods: This randomized, single-blind, placebo-controlled, pilot study administered intravenous ketamine to individuals with tobacco use disorder recruited from the local community. Participants were randomized to receive either ketamine (0.5 mg/kg) ( = 6) or saline placebo ( = 4) over 20 min. Primary outcomes included measures of drug safety and tolerability during and within an hour after the infusion. Secondary outcomes included measures of tobacco use, craving, and withdrawal before, and 24-hours after, the drug infusion study day. A follow-up visit occurred eight days after the infusion.

Results: Intravenous ketamine was well tolerated with transient side effects. No significant effects were noted on cigarette smoking, craving, or withdrawal symptoms on the post-infusion visit following overnight abstinence or on the follow-up visit ( > 0.05).

Conclusions: Although limited by the small sample size, this pilot study extends previous research on ketamine for substance use disorders. While ketamine was well tolerated in this sample, additional research testing different ketamine doses and administration routes is necessary to determine whether ketamine has therapeutic potential for tobacco use disorder.