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Alcohol Use Disorder (AUD)Phase 1/2KET-DUALNCT07247370

Ketamine-Enhanced Therapy for Individuals With Alcohol Use Disorder and Depression: A Pilot Study (KET-DUAL)

A Phase 1/2 study testing Ketamine and Cognitive Behavioural Therapy in people with Alcohol Use Disorder (AUD) and Major Depressive Disorder (MDD), run by South West Sydney Local Health District at 1 site in Australia.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

To assess the safety, feasibility and preliminary efficacy of ketamine-enhanced therapy (KET) for alcohol use disorder (AUD) and comorbid major depressive disorder (MDD) in an open-label, single arm, pilot clinical trial. Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
Ketamine and Cognitive Behavioural Therapy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteAustralia
Study dates
10 Dec 2025to 10 Dec 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Moderate to severe AUD according to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) criteria
  • Presence of current Major Depressive Disorder (MDD), according to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-V) criteria
  • Expressed motivation to reduce or cease alcohol consumption.
  • Consumed at least 21 standard drinks per week or 2 HDD per week (≥5 standard drinks/day for men; ≥4 for women) in the month prior to screening
  • Age 18-70
  • Adequate cognition and English language skills to give valid consent and complete research interviews
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  • Stable housing
  • Willingness to give written informed consent.
  • Willingness to comply with study procedures and attend scheduled visits.

Who cannot join

  • DSM-5 diagnosis of current or past psychotic disorder, bipolar I disorder, or substance-induced psychosis.
  • Current acute suicidality, defined as high risk by the Columbia Suicide Severity Rating Scale (C-SSRS) or clinical judgment or attempts in the past 6 months.
  • DSM-5 diagnosis of current or past moderate-to-severe ketamine or other dissociative drug use disorder.
  • Use of ketamine (prescribed or non-prescribed) in the previous 4 weeks.
  • Enrolment in another interventional clinical trial that may interfere with safety, data quality, or trial participation.
  • Pregnant or breastfeeding, or planning to become pregnant during the course of the study.
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  • Significant uncontrolled medical conditions, including but not limited to:
  • Severe or poorly controlled hypertension (>160/100 mmHg)
  • Severe cardiovascular disease (e.g., heart failure, recent myocardial infarction, dysrhythmia)
  • History of stroke, cerebral trauma, or intracranial mass/haemorrhage
  • Severe hepatic impairment (e.g., MELD ≥10) or end-stage liver disease, bladder or kidney disease
  • Clinically significant alcohol withdrawal at screening (e.g., CIWA-Ar ≥10, history of delirium tremens).
  • History of heightened intracranial pressure, seizures, or diagnosed seizure disorder (except childhood febrile seizures).
  • Known hypersensitivity to ketamine or any excipients.
  • Concurrent use of psychotropic medications (other than stable-dose antidepressants ≥4 weeks).
  • Active substance use disorder (moderate or severe) other than nicotine or caffeine; stable opioid use disorder permitted if on maintenance therapy (with strict stability criteria).
  • Inability or unwillingness to comply with study procedures, judged by the principal investigator.
  • Any clinically significant medical or psychiatric condition that, in the judgment of the Principal Investigator, poses a safety risk or could confound study results or hinder protocol adherence.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Kirsten C Morley, PhD contact

+61295153636

Kirsten.morley@sydney.edu.au

Ellen Towers contact

ellen.towers@sydney.edu.au

Australia1 site
  • Drug Health Services, Royal Prince Alfred Hospital

    Sydney, New South Wales, 2050

    Kirsten Morley, PhD, Kirsten.morley@sydney.edu.au

    Central Contact Line, 0459877108

Other trials in Australia

About this study

Official title: An Open-label Pilot Evaluation of Ketamine-Enhanced Psychotherapy in Individuals With Alcohol Use Disorder (AUD) and Co-morbid Major Depressive Disorder (MDD)

To assess the safety, feasibility and preliminary efficacy of ketamine-enhanced therapy (KET) for alcohol use disorder (AUD) and comorbid major depressive disorder (MDD) in an open-label, single arm, pilot clinical trial.

Read the detailed description

New strategies for the treatment of alcohol use disorder (AUD) and co-morbid major depressive disorder (MDD) are urgently required. This population represents a high-risk group that has largely been excluded from addiction-focused trials despite its clinical complexity and poor response to standard interventions.

Recent early phase studies have shown that ketamine-enhanced psychotherapy (KET) can reduce alcohol consumption, enhance motivation and alleviate depressive symptoms. Effects have been shown to be particularly pronounced among participants who also received motivational enhancement therapy, suggesting a synergistic effect between ketamine and psychotherapy.

Emerging evidence suggests that KET may be of promise for AUD, and has demonstrated a good safety profile and potential efficacy in alcohol dependence. However, no trials to date have specifically targeted AUD and co-morbid MDD.

This project will assess the clinical safety, feasibility and preliminary efficacy of KET in individuals with AUD and co-morbid MDD. The investigators hypothesise that KET will be safe and feasible to deliver in this population, and expect to observe preliminary improvements in alcohol consumption, depressive symptoms, and treatment engagement. The KET intervention is also anticipated to be well tolerated with high levels of session attendance and acceptable rates of adverse events.

The trial will utilise an open-label, single-arm, pilot clinical trial design. A sample of 20 individuals will receive 6 weeks of treatment including 6 manualized cognitive-behavioural therapy sessions and 3 dosing sessions with Ketamine administered at 2 week intervals (0.7mg/kg initially up).

Being tested
Ketamine, Cognitive Behavioural Therapy
Keywords
Ketamine-enhanced psychotherapy, Open-label, Single-arm, Ketamine, Concurrent Treatment of AUD and comorbid MDD, Alcohol Use Disorder (AUD), Major Depressive Disorder (MDD)
Medical subject headings
Alcoholism, Depressive Disorder, Major

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KetamineDrug

    Subcutaneous administration of of Ketamine across 3 dosing sessions (at week 2, 4 and 6). Dosing adjustments are permitted based on tolerability, with a minimum dose of 0.7mg/kg and a potential maximum of 1.2 mg/kg, at the discretion of the principal investigator (previous studies have found efficacy at 0.8mg/kg for AUD).

  • Cognitive Behavioural TherapyBehavioural

    Also called CBT, Psychotherapy

    This study uses a manualized CBT program adapted for ketamine-assisted context. It integrates evidence-based CBT for substance use and depression with principles of psychedelic-assisted therapy, including "set and setting." considerations central to psychedelic-assisted therapy. The therapist manual includes guidance on psychological preparation, intention-setting, integration, and therapeutic framing of ketamine experiences. Participants receive six 90-minute sessions over six weeks, delivered by trained health professionals (e.g., psychologists, mental health nurses, social workers) with specific training in the adapted CBT protocol and psychedelic-assisted therapy. Sessions include:

    Preparation (Week 1): Review of alcohol use, treatment goals, and ketamine orientation.

    Integration (Weeks 2, 4, 6): Post-dose processing and linking experience to recovery goals occurring 24-48 hours post dose.

    Continued CBT (Weeks 3, 5): Coping strategies, goal setting, and relapse prevention.

Study groups in NCT07247370
Study groupRoleWhat they receive
Ketamine-enhanced therapy (KET): sub-anesthetic ketamine plus structured psychotherapyExperimental1. x CBT session (Week 1) Dose 1: 1x Sub-anaesthetic subcutaneous dose of racemic ketamine (initially 0.7mg/kg, up to a potential maximum of 1.2mg/kg, at the discretion of the principal investigator and permitted based on tolerability) (Week 2) 2. x CBT sessions (Week 2 - 3) Dose 2: 1x Sub-anaesthetic subcutaneous dose of racemic ketamine (initially 0.7mg/kg, up to a potential maximum of 1.2mg/kg, at the discretion of the principal investigator and permitted based on tolerability (Week 4) 2 x CBT sessions (Week 4 - 5) Dose 3: 1x Sub-anaesthetic subcutaneous dose of racemic ketamine (initially 0.7mg/kg, up to a potential maximum of 1.2mg/kg, at the discretion of the principal investigator and permitted based on tolerability (Week 6) 1x CBT session (Week 6)
Receives: Drug: Ketamine; Behavioral: Cognitive Behavioural Therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Feasibility will be assessed through recruitment rates, retention to follow-up, session attendance, and treatment adherence.

    Feasibility outcomes will be assessed by the traffic light framework may be applied to guide progression decisions for future trials for each of the following variables: (i) time taken to recruit the sample; (ii) proportion of ineligible participants at (a) pre tele-screening and (b) onsite screening; (iii) number of participants who receive (a) at least two doses of ketamine and (b) at least four CBT sessions; (iv) retention rate over the trial. As this is the first study of its kind in this population and pilot studies are not generalisable to other contexts, these will be assessed and reported descriptively. Results will be synthesised in consideration of the feasibility to progress to larger studies, taking into account the measures described above. Specifically, based on our prior trials of CBT, pharmaco-assisted therapy and complex S9 trials, the following would be an estimation of failure to progress to full trial for each variable and when taken together: (i) > 24 months; (ii)

    Measured: 22 weeks

  2. Safety will be assessed through the frequency, severity, and relatedness of adverse events (AEs), including dissociation, affective destabilisation, and vital sign abnormalities.

    Safety outcomes including adverse events (AEs), serious adverse events (SAEs), and vital sign abnormalities, will be summarised descriptively across the study period. Feasibility outcomes (e.g., recruitment and retention rates, session attendance) will be analysed using proportions with corresponding 95% confidence intervals.

    Measured: 22 weeks

Secondary outcomes (4)
  1. Number of Heavy Drinking Days per week (HDDs) (>5 standard drinks/day for men; >4 for women) and total alcohol consumption.

    This will be measured by the Timeline Follow Back and corroborated with Phosphatidylethanol (PEth) levels

    Measured: 22 weeks

  2. Change in depressive symptoms measured by MADRS and DASS-21.

    MADRS is a clinician-administered rating scale designed to assess the severity of depressive episodes in patients with mood disorders. It is widely used in clinical trials and psychiatric evaluations due to its sensitivity to treatment-related changes. The MADRS will be administered by trained health care professionals.

    The MADRS total score is calculated by summing the scores of 10 individual items, each rated on a scale from 0 to 6, yielding a total score range of 0 to 60. Higher scores indicate greater severity of depressive symptoms.

    The 10 items assessed in the MADRS include:

    Apparent sadness Reported sadness Inner tension Reduced sleep Reduced appetite Concentration difficulties Lassitude/Sluggishness Inability to feel (emotional capacity) Pessimistic thoughts Suicidal thoughts

    Each item is rated based on clinical judgment following a semi-structured interview, focusing on the past week.

    Clinically meaningful changes will be reported descriptively, including rates of ≥50%

    Measured: 22 weeks

  3. Changes in suicidal ideation (weekly monitoring) using the Columbia Suicide Severity Rating Scale (C-SSRS).

    The C-SSRS is a structured clinician-administered instrument with strong predictive validity for suicidal behavior, used in clinical and research settings to assess the presence, severity, and intensity of suicidal ideation and behavior. The C-SSRS is administered by trained clinicians.

    C-SSRS scoring includes four subscales: ideation severity (items 1-5, scored by the most severe type endorsed); intensity of ideation (sum of five items including frequency, duration, controllability, deterrents, and reasons for ideation; range 2-25; higher number indicates more intense ideation); suicidal behavior (presence or absence of actual, interrupted, aborted, or preparatory behavior recorded separately); and potential lethality (medical damage rated 0-5, potential lethality rated 0-2). At baseline, this is measured by the baseline version. At each visit following this, this will be recorded on the since last visit. Higher scores indicate more severe suicidality.

    Measured: 22 weeks

  4. Changes in Positive and Negative Mood States

    Mood states before/after ketamine sessions assessed by PANAS (Positive and Negative Affect Schedule). This will be measured at integration session 1 (week 2), 2 (week 4) and 3 (week 6). Used to measure an individual's emotional state, assessing two dimensions: Positive Affect (PA; captures feelings like enthusiasm and alertness), and Negative Affect (NA; measures distress and negative emotions like anger and anxiety).

    Measured: Week 2 (integration session 1), Week 4 (integration session 2), Week 6 (optional - at ketamine dose 3), Week 6 (integration session 3 and end of treatment)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Nov 2025
  2. Study start10 Dec 2025 (estimated)
  3. Primary completion10 Apr 2027 (estimated)
  4. Study completion10 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Open-label, single-arm, pilot study assessing the safety, feasibility, and preliminary efficacy of ketamine-enhanced therapy (KET) for individuals with alcohol use disorder (AUD) and co-morbid major depressive disorder (MDD) Participants will receive 3 doses of sub-anaesthetic ketamine combined with structured psychotherapy over six weeks, followed by follow-up assessments.
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07247370
Sponsor's protocol ID
X25-0138
Acronym
KET-DUAL
Status last verified
Nov 2025
First submitted
16 Nov 2025
Last updated
25 Nov 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Ketamine and Cognitive Behavioural Therapy in people with Alcohol Use Disorder (AUD) and Major Depressive Disorder (MDD), run by South West Sydney Local Health District at 1 site in Australia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 25 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Kirsten C Morley, PhD (+61295153636, Kirsten.morley@sydney.edu.au), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility will be assessed through recruitment rates, retention to follow-up, session attendance, and treatment adherence. (time frame: 22 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Nov 2025; AzTrials last refreshed its copy on 7 Nov 2026.

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