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Ketamine is now being studied for psychiatric applications other than treatment-resistant depression and suicidality, with possible value found for ketamine in cocaine dependence. Ketamine might share an overlapping mechanism of action with mindfulness, which is of interest because mindfulness-based relapse prevention (MBRP; a blend of mindfulness and cognitive-behavioral therapy) has modest efficacy for cocaine use disorder. These investigators randomized 55 cocaine-dependent patients (mean age, 47; 67% black; 26% women) to intravenous ketamine or midazolam; all participants received MBRP.
About 64% of participants freebased cocaine, and 24% were intranasal users (alcohol use disorder, 22%; post-traumatic stress disorder, 14%). Each patient…