Abstract

Substance treatment services are often not equipped to treat individuals with other mental health problems; similarly, mental health services do not treat patients with current drug and alcohol problems. Conventional anti-depressants are at best only mildly effective in substance use disorders (SUD), which is problematic as depressive symptoms precipitate relapse. Psychedelic drugs in combination with therapy offer a real potential to tackle both co-morbid mental health issues and substance use disorders simultaneously, particularly tackling depressive symptoms in the risky window for relapse post detoxification.

We will present here data from our Phase II clinical trial showing reductions in transdiagnostic mental health symptoms (anhedonia and repetitive negative thinking) at three months post treatment with ketamine assisted therapy in people with alcohol use disorder. These reductions were especially pronounced in those with a family history of alcohol problems. This extends previous findings that demonstrated that ketamine produces a more robust anti-depressant effect in treatment-refractory depressed individuals with a family history of alcohol use disorder (AUD) compared to those without.

We explore both data suggesting genetic and life course (early life stress) explanations for these enhanced effects in people with family history of substance use. We also will present new data from a mechanistic study looking at ketamine administration in people with behavioral addiction, showing how changes in neuroplasticity (via electroencephalographic EEG recordings of long term potentiation related brain electrical activity), depressive symptoms and craving interact.

Overall, these data will be interpreted in the wider context of psychedelic drugs to conclude what powerful agents, when combined with psychological therapies, these medicines may prove for tackling co-morbidity in mental health and substance use disorders.