A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’ project

Griffiths, Chris; Walker, Kate; Reid, Isabel; Silva, Ksenija Maravic da; O’Neill-Kerr, Alex

doi:10.1016/j.jadr.2021.100079

Cited by 15 publications

(20 citation statements)

References 30 publications

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“…6 -a study about potential new treatments for TRD; Griffiths et.al. 5 -a study about the evaluation of ketamine's antidepressant and adverse effects on TRD; Hudgens et. al.…”

Section: Hudgens Et Al 1 Journal Of Affective Disordersmentioning

confidence: 99%

“…In many situations, the combination of two or more of these drugs is not able to cease the patient's depressive symptoms, raising him to the diagnosis of treatment-resistant depression. 1,5 In this sense, the need for more effective treatments, with a faster onset of action, better dosage, and fewer side effects has increased in recent years and new therapeutic approaches for depressed patients have emerged aiming to reduce the unfavorable outcomes resulting from this pathology.…”

Section: Introductionmentioning

confidence: 99%

“…However, both a long-term analysis and an understanding of the mechanism of action of the drug associated with the physiological processes of depression and the heterogeneity of the study group are extremely useful to understand and attest to the effectiveness of new therapies. 4,5 Given this situation and taking into account that 20 to 30% of individuals with major depressive disorder (MDD) develop treatment-resistant depression (TRD) 6 , we aim to develop a systematic review of the literature regarding the new possibilities of pharmacological treatments for depression based on the acronym PICO: P: study population -people with depressive disorder according to DSM V 296.21, 296.22, 296.23 and 296.24; I: intervention -to demonstrate the effectiveness of new pharmacological therapies for depression; C: control -individuals with MDD and TRD; O: outcome -new pharmacological approaches to depressive disorders. This question has had a greater impact in recent years due to the need for new pharmacological treatments since the number of patients with TRD and MDD who respond inadequately to conventional treatment is increasing.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy in the treatment of depressive disorders

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et al. 2022

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Introduction Depression, being the most disabling disease in the world and presenting high morbidity and mortality, requires an effective treatment to ensure the maintenance of the patients' quality of life. About a third of patients do not respond adequately to antidepressant treatment. New pharmacological therapies are being approached in order to reduce the unfavorable outcomes resulting from this pathology. Objective To develop a systematic review of the literature on the new possibilities of pharmacological treatments for depression in the last four years. Method A systematic review was carried out following the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). We have included studies on the effectiveness of new pharmacological therapies in patients with major depressive disorder and treatment-resistant depression. Results In the treatment of the major depressive disorder (MDD), the use of brexpiprazole 1 mg/day in addition to the usual antidepressant treatment (ADT) resulted in significant improvement in the main symptoms. Already referring to treatments for treatment-resistant depression (TRD): nasal esketamine proved beneficial in the short term, intravenous (IV) ketamine also appears as an effective therapy. Conclusion The use of brexpiprazole 1 mg/day associated with an antidepressant, and the use of lactobacilli represent a new option for those with MDD. In addition, both ketamine, riluzole, and cariprazine appear as new hopes for those who have not yet achieved remission of the depressive disorder with the use of more than two antidepressants

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“…6 -a study about potential new treatments for TRD; Griffiths et.al. 5 -a study about the evaluation of ketamine's antidepressant and adverse effects on TRD; Hudgens et. al.…”

Section: Hudgens Et Al 1 Journal Of Affective Disordersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy in the treatment of depressive disorders

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et al. 2022

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“…A small number of studies demonstrate the therapeutic effects of ketamine on drug abstinence, drug use, craving and withdrawal [see (7) for a review], and most recently alcohol use disorder (8,9). Although the safety and efficacy of ketamine has been well-established, few studies thus far have looked at the phenomenological experiences of people who have been given the drug therapeutically and how these relate to mechanisms of therapeutic benefits (10,11).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, ketamine's therapeutic effects on motivation to quit cocaine and cocaine use were mediated by ketamine's mystical type effects-but not dissociative effects (16,17). Whilst some studies (18,19) have described the experiences during treatment, there have been no qualitative studies of the experiences of participants during ketamine treatment for alcohol use disorders, and as far as we are aware of only a handful of studies that have looked at ketamine experiences qualitatively in any treatment setting (10,11).…”

Section: Introductionmentioning

confidence: 99%

“This Is Something That Changed My Life”: A Qualitative Study of Patients' Experiences in a Clinical Trial of Ketamine Treatment for Alcohol Use Disorders

et al. 2021

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Background: The therapeutic benefits of ketamine have been demonstrated for a variety of psychiatric disorders. However, the role of ketamine induced psychoactive experiences in mediating the therapeutic effects is unclear. Despite the growing quantitative research on the efficacy of ketamine treatment, very few studies examined participant experiences of ketamine infusions in a treatment setting.Aims: The current study aimed to examine participant experiences of ketamine infusions and how these relate to therapeutic mechanisms in a clinical trial setting.Methods: We conducted semi-structured interviews with 12 participants who received up to three ketamine infusions (0.8 mg/kg) as part of a Phase II double blind, randomised controlled trial. The interviews explored participants' acute experiences of ketamine infusions, experiences of psychotherapy/education, and the lasting effects of the trial. The interviews were transcribed verbatim and analysed using thematic analysis.Results: Six key themes were identified. (1) Participants reported multifaceted motivations for trial participation. (2) The set and setting was found to be influential in determining acute ketamine experiences. The acute ketamine experiences included: (3) the inherent contradictions of the experience (e.g., dissociation vs feelings of connection), (4) rapidly fluctuating and changing experiences, (5) meaningful, mystical and spiritual experiences. Finally, the final theme (6) relates to the transformational effects of the infusions and the trial.Conclusion: Provided in a supportive and professional environment, ketamine treatment led to a significant change in relationship with alcohol. Ketamine induced ego dissolution and dissociation were reported to be related to the transformational effects on relationship with alcohol. The extent to which the acute psychoactive effects of ketamine mediate therapeutic effects on drinking outcomes remain to be investigated in the trial data. The acute effects of ketamine reported by our participants transcend its traditional conceptualisation as a “dissociative anaesthetic”; therefore, we suggest the development or use of new measures alongside ketamine infusions to fully capture the spectrum of these effects which may be crucial in its therapeutic and transformative effects.

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Phenomenology and therapeutic potential of patient experiences during oral esketamine treatment for treatment-resistant depression: an interpretative phenomenological study

et al. 2023

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Background Ketamine and its enantiomers are widely researched and increasingly used to treat mental disorders, especially treatment-resistant depression. The phenomenology of ketamine-induced experiences and their relation to its psychotherapeutic potential have not yet been systematically investigated. Aims To describe the phenomenology of patient experiences during oral esketamine treatment for treatment-resistant depression (TRD) and to explore the potential therapeutic relevance of these experiences. Methods In-depth interviews were conducted with 17 patients after a 6-week, twice-weekly ‘off label’ generic oral esketamine (0.5–3.0mg/kg) treatment program. Interviews explored participants’ perspectives, expectations, and experiences with oral esketamine treatment. Audio interviews were transcribed and analyzed using an Interpretative Phenomenological Analysis (IPA) framework. Results The effects of ketamine were highly variable, and psychological distress was common in most patients. Key themes included (a) perceptual effects (auditory, visual, proprioceptive), (b) detachment (from body, self, emotions, and the world), (c) stillness and openness, (d) mystical-type effects (transcendence, relativeness, spirituality), and (e) fear and anxiety. Key themes related to post-session reports included (a) feeling hungover and fatigued, and (b) lifting the blanket: neutralizing mood effects. Conclusion Patients reported several esketamine effects with psychotherapeutic potential, such as increased openness, detachment, an interruption of negativity, and mystical-type experiences. These experiences deserve to be explored further to enhance treatment outcomes in patients with TRD. Given the frequency and severity of the perceived distress, we identify a need for additional support in all stages of esketamine treatment.

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A qualitative study of patients' experience of ketamine treatment for depression: The ‘Ketamine and me’ project

Cited by 15 publications

References 30 publications

Efficacy in the treatment of depressive disorders

Efficacy in the treatment of depressive disorders

“This Is Something That Changed My Life”: A Qualitative Study of Patients' Experiences in a Clinical Trial of Ketamine Treatment for Alcohol Use Disorders

Phenomenology and therapeutic potential of patient experiences during oral esketamine treatment for treatment-resistant depression: an interpretative phenomenological study

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