Table 6.
Summary of studies using classic and atypical psychedelics for cocaine use disorder
| Substance | Author(s) | Year | Study characteristics | Drug and dose | Main findings |
|---|---|---|---|---|---|
| a. Ketamine | Dakwar et al. [65] | 2014 | Crossover double-blind randomised trial | K1: 0.41 mg/kg | K1 relative to LZP significantly |
| Eight cocaine dependent (DSM-IV) non-treatment and non-abstinence seeking | K2: 0.71 mg/kg | 1. increased motivation for changing cocaine use | |||
| Three infusions of sub-anaesthetic psychoactive dose of ketamine (K1, K2) or active control lorazepam (LZP) | LZP: 2 mg | 2. Decreased cue-induced cocaine craving | |||
| K2 further reduced cue-induced craving | |||||
| Observed trend in craving reduction following K1 | |||||
| Dakwar et al. [66] | 2017 | Crossover double-blind randomised trial | Ketamine HCl: 0.71 mg/kg | Ketamine relative to midazolam significantly reduced cocaine self-administration by 67% | |
| Twenty cocaine dependent (DSM-IV) non-depressed, non-treatment and non-abstinence seeking | Midazolam: 0.025 mg/kg | Ketamine led to significant reductions in cocaine use and cocaine craving initially, but was not sustained after several days | |||
| Cocaine self-administration paradigm | |||||
| Two infusions of sub-aesthetic dose of ketamine or of the active control midazolam | |||||
| Dakwar et al. [67] | 2019 | Randomised clinical trial | Ketamine HCl: 0.5 mg/kg (iv) | 48.2% abstinence (last 2 weeks of trial) in the ketamine group compared to 10.7% in the midazolam group | |
| Fifty-five treatment-seeking cocaine dependent (DSM-IV) individuals | Midazolam: 0.025 mg/kg (iv) | In the ketamine group compared to the midazolam group | |||
| 5-week course of MBRP and were randomly assigned to receive ketamine or active control midazolam during week 1 | 1. Was 53% less likely to relapse (use cocaine/drop out) | ||||
| 2. Craving was 58.1% lower | |||||
| 44% of the ketamine group reported abstinence at 6-month telephone follow-up relative to none of the participants in the midazolam group | |||||
| b. Classic psychedelics | Jones et al. [59] | 2022 | Association study | Psilocybin | Peyote was the only substance associated with lower odds of CUD (decrease by 50%) |
| 214,505 responders who met CUD criteria and completed the NSDUH from 2015 to 2019 | LSD | ||||
| Mescaline/peyote | |||||
| Dose N/A |
CUD, cocaine use disorder; DSM, Diagnostic and Statistical Manual of Mental Disorders; HCl, hydrochloride; LSD, lysergic acid diethylamide; LZP, lorazepam; NSDUH, National Survey on Drug Use and Health; MBRP, mindfulness-based relapse prevention.