From Yale to the lab in St. Petersburg
Evgeny Krupitsky, M.D., Ph.D.
Leningrad Regional Center for Alcoholism and Drug Addiction Therapy

In the second quarter of 1997, MAPS donated $8,000 to this study investigating the effectiveness of ketamine-assisted psychotherapy in the treatment of people with heroin dependency.

I completed my one year research project at Yale in March and started to work in my laboratory in St. Petersburg, Russia in April of this year. Before I left Yale, I was only able to get Institutional Review Board (IRB) approval for my protocol of the s tudy of ketamine-nimodipine interaction in alcoholic patients and to run the first patient in that study. I hope very much that Dr. Krystal's research team will continue the study. Also, a grant application submitted by Dr. Krystal and myself to the Civilian R esearch and Development Foundation is now being reviewed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). If we are receive the grant we will conduct that study as a collaborative re-search project in parallel both in St. Petersburg and at Yale.

Upon my return to St. Petersburg I found the situation in my lab much worse then it was a year ago; the staff is paid very poorly and with delay, the budget is small, and it has been necessary to do a small repair in my office. The situation has gotten mu ch worse on the whole in Russia within the last year, particularly after the presidential election. Nevertheless, with support from MAPS, we are actively conducting the study of the clinical efficacy and underlying psychological mechanisms of ketamine-assisted psychotherapy of people with heroin dependency. MAPS arranged for the protocol to be reviewed and critiqued by several experts in drug abuse treatment research so that the results of the study will be taken seriously in the United States. The staff of my laboratory began treating patients in the fall of 1996 when I was at Yale. At the present we h ave treated 15 patients (eight in the experimental group and seven in the control group). It is interesting to note that a very low non-hallucinogenic injected dose of ketamine given to the patients in the control group appeared to be quite effective for guided imagery and visual-ization during the psychotherapy. We hope to be able to inform MAPS Bulletin readers about the preliminary results of the first year of this three-year study in the fall of 1997.

Also, we are doing the statistical analysis of data collected in the previous MAPS-supported study of underlying psychological mechanisms of ketamine-assisted psychotherapy of alcoholic patients, which was carried out in 1995. This analysis will examine w hether there are any correlations between treatment outcome and individual psychological traits and their changes caused by ketamine therapy. We hope this analysis will help us to define some individual indications for ketamine therapy as well as to better understand the underlying psychological mechanisms of treatment outcome.

We would like to express our deepest gratitude to MAPS for the support of our ketamine research which otherwise would not be possible. I am also grateful for the computer which MAPS presented to me when I was in the United States. That computer allowed me to work at home at nights and during the weekends, and also to access the Internet at home, which made my one year at Yale much more productive.