Brief Report: Intranasal Ketamine in Adolescents and Young Adults with Autism Spectrum Disorder-Initial Results of a Randomized, Controlled, Crossover, Pilot Study.

Researchers gave teens and young adults with autism two doses of intranasal ketamine or placebo in a crossover design. They wanted to see if the drug would reduce social withdrawal.

The team tracked side effects and social behavior after each dose. The study was small and short-term, meant to test safety first.

Ketamine was safe and did not cause extra side effects. Yet it did not make participants less withdrawn or more social.

The null result held for both the 30 mg and 50 mg doses. The drug simply did not move the social needle.

EGranieri et al. (2020) and Ibrahim et al. (2021) show behavioral or social-cognitive training can boost social skills in similar youth. These positive findings contrast with the null ketamine result, pointing to skill building over a single drug spray.

Facon et al. (2021) also piloted a biological treatment—fMRI neurofeedback—and saw early positive signals. The difference: their neural feedback trained the social brain across eight weeks, while ketamine was a quick chemical dose.

McAuliffe et al. (2017) and Chan et al. (2018) found parent-reported social gains after weeks of group sessions. Again, repeated practice beat a single pharmacological nudge.

For BCBAs, the message is clear: social withdrawal in ASD responds to structured teaching, not a quick ketamine spray. Keep using peer-mediated groups, social stories, and practice loops. Save the drug route for future larger trials—and only under medical watch.