The drug liking and craving questionnaire (DLCQ) to evaluate addiction risk for ketamine and esketamine

Abstract

Ketamine and esketamine (SPRAVATO) are rapid acting antidepressants that have gained evidence and popularity in recent years in treating depression, and are under investigation for other psychiatric indications. Ketamine is a potential drug of abuse and the addiction potential of these medications has been repeatedly cautioned in the psychiatric literature. However, no studies have included a systematic evaluation of addiction potential in their research so risk of this harm remains theoretically and has not been quantified to place in properly in a risk/benefit perspective. There is currently no easily accessible and ready to use tool for this purpose, which poses a barrier to including measures of addiction potential in ketamine and esketamine research. Based on review of the literature and a recently suggested comprehensive Ketamine Side Effect Tool (KSET), as well as the United States Food and Drug Administration recommendations for evaluation addictive potential of a drug, we created a simple, patient rated visual analog scale specifically for assessing ketamine/esketamine drug likeability, cravings and temptation to misuse. While this scale is not validated, in the absence of other accessible tools, use of this questionnaire would provide researchers and clinicians a simple and easy to use tool to begin monitoring addictive potential in patients taking ketamine or esketamine, and better inform future research, clinical practice and publicy policy regarding these substances.

Keywords

• Ketamine
• Esketamine
• Depression
• Addiction
• Drug likeability
• Cravings