ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2018
Adjunctive Use of Ketamine for Benzodiazepine-Resistant Severe Alcohol Withdrawal: a Retrospective Evaluation.
Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 43 citations in OpenAlex.
- Single-dose intravenous ketamine or intramuscular naltrexone for high-utilization inpatients with alcohol use disorder: pilot trial feasibility and readmission rates.Addiction science & clinical practice · 2022Trial
- Ketamine Dosing Across Clinical Indications: A Narrative Review Organized by Proposed NMDA-Related Mechanisms.Journal of clinical pharmacology · 2026Review
- Review
- Trends in alcohol withdrawal management by medical toxicologists in the acute care setting: an analysis of the Toxicology Investigators Consortium (ToxIC) Core Registry, 2016-2022.Alcohol and alcoholism (Oxford, Oxfordshire) · 2025Article
- Ketamine-From an Anesthetic to a Psychiatric Drug: Mechanisms of Action, Clinical Applications and Potential Risks.Molecules (Basel, Switzerland) · 2025Review
- A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder.Brain sciences · 2024Review
- Review of Attributes and Outcomes of Hospitalized Patients with Alcohol Withdrawal.Journal of community hospital internal medicine perspectives · 2024Article
- Review
- The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review.Frontiers in psychiatry · 2023Article
- Multicenter Retrospective Review of Ketamine Use in the ICU.Critical care explorations · 2022Article
- Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review.BJPsych open · 2021Review
- Article
- Management of Alcohol Withdrawal in the Emergency Department: Current Perspectives.Open access emergency medicine : OAEM · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionBenzodiazepine (BZD)-resistant alcohol withdrawal remains a challenge for most institutions due to limited evidence with available agents. One published study currently exists utilizing the N-methyl-D-aspartate antagonist, ketamine, for alcohol withdrawal.
objectiveThe purpose of our study was to evaluate the effect of adjunctive ketamine continuous infusion on symptom control and lorazepam infusion requirements for BZD-resistant alcohol withdrawal patients in the intensive care unit.
methodsA retrospective review was conducted of patients receiving ketamine adjunctively with a lorazepam infusion for severe alcohol withdrawal between August 2012 and August 2014. Outcomes included time to symptom control, lorazepam infusion requirements, ketamine initial and maximum daily infusion rates, and adverse effects of ketamine.
resultsThirty patients were included in the analysis. Mean time to initiation of ketamine after the initiation of a lorazepam infusion was 41.4 h. All patients achieved initial symptom control within 1 h of ketamine initiation. Median initial ketamine infusion rate was 0.75 mg/kg/h and the average maximum daily rate was 1.6 mg/kg/h. Significant decreases in lorazepam infusion rates from baseline were observed at 24 h (- 4 mg/h; p = 0.01) after ketamine initiation. No patients experienced documented CNS adverse effects. Two patients experienced hypertension and no patients experienced tachycardia related to ketamine.
conclusionAdjunctive ketamine could provide symptom control for BZD-refractory patients and may potentially reduce lorazepam infusion requirements. Future studies to determine optimal dosing, timing of initiation, and place in therapy for BZD-resistant alcohol withdrawal are needed. The mechanism of action via the NMDA receptor with ketamine may provide benefit for BZD-resistant alcohol withdrawal.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.