A 2023 study published in the journal Addiction presents a multifaceted investigation into repurposing ketamine as a treatment for cocaine use disorder (CUD), combining artificial intelligence (AI)-based prediction, expert clinical validation, and biological mechanism modeling. The study, available via Wiley Online Library, is a landmark example of translational research that bridges data science, clinical evidence, and neuropharmacology.
The findings strongly suggest that ketamine may play a key role in reducing cocaine cravings and relapse, offering new hope for one of the most treatment-resistant substance use disorders.
Study Overview
- Title: Repurposing ketamine to treat cocaine use disorder: integration of artificial intelligence-based prediction, expert evaluation, clinical corroboration and mechanism of action analyses
- Journal: Addiction (Wiley, 2023)
- Authors: Wang et al.
- Study Components:
- AI algorithm to identify candidate compounds for CUD treatment
- Expert clinical review of top candidates
- Real-world data analysis for clinical effectiveness
- Mechanistic modeling of pharmacological action
Key Findings
1. AI Prediction Model Identifies Ketamine as a Top Candidate
- AI systems screened over 450 FDA-approved drugs using patient datasets and treatment-outcome simulations
- Ketamine emerged as one of the most promising agents linked to significantly improved outcomes in patients with CUD
2. Clinical Validation Supports AI Predictions
- Retrospective review of electronic health records (EHRs) confirmed that patients receiving ketamine had 2–4× higher remission rates compared to matched controls
- Clinical experts rated ketamine highly for its potential efficacy, safety, and pharmacological plausibility
3. Mechanistic Analyses Confirm Biological Rationale
- Ketamine acts on:
- NMDA receptors, modulating glutamate transmission disrupted in cocaine dependence
- Dopamine reward circuits, weakening cocaine cue-reactivity
- mTOR and BDNF pathways, enhancing synaptic plasticity for behavioral change
The Case for Repurposing Ketamine
This study exemplifies the power of drug repurposing: identifying new uses for existing medications based on large-scale, data-informed strategies. Key advantages include:
- Established safety profile in medical settings
- Reduced time and cost compared to novel drug development
- Emerging use in depression and PTSD builds regulatory momentum
Real-World Impact for Cocaine Addiction
- Cocaine use disorder remains without any FDA-approved medication
- Current behavioral therapies show limited success and high relapse rates
- Ketamine may:
- Rapidly reduce cravings
- Interrupt compulsive drug-seeking behavior
- Provide a window of neuroplasticity for psychological change
Recommendations and Next Steps
The authors recommend:
- Prospective clinical trials to confirm real-world findings
- Investigation into optimal dosing strategies
- Integration with cognitive-behavioral therapy or motivational enhancement therapy
- Expansion of ketamine research into stimulant-specific addiction care models
Final Thoughts
This multi-tiered study presents ketamine as a high-potential candidate for treating cocaine use disorder, supported by AI modeling, clinical data, and mechanistic rationale. With few effective options available for stimulant addiction, this approach highlights how modern technology and neuroscience can accelerate breakthroughs in addiction psychiatry.
Reference
Wang et al. (2023). Repurposing ketamine to treat cocaine use disorder: integration of artificial intelligence-based prediction, expert evaluation, clinical corroboration and mechanism of action analyses. Addiction. Wiley Online Library
