Treating addiction with an addictive drug: the ketamine paradox revisited

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Ketamine has emerged as a potential intervention for treatment-resistant depression and substance use disorders due to its rapid neuroplastic effects.
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Clinical trials indicate that ketamine combined with psychotherapy may reduce cravings and increase abstinent days in alcohol and cocaine use disorders.
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Variability in dosing strategies and follow-up periods limits the generalizability of ketamine's efficacy in treating substance use disorders.
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Ketamine promotes synaptic plasticity through NMDA receptor antagonism, potentially disrupting maladaptive reward-related memories.
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Despite its therapeutic potential, ketamine carries a risk of misuse, particularly in unsupervised or high-dose settings.

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