Ketamine Analgesia and Psychedelia: Can We Dissociate Dissociation?

Mashour, George A.

doi:10.1097/aln.0000000000004172

Cited by 8 publications

(2 citation statements)

References 13 publications

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“…1 and the accompanying editorial by Mashour. 2 In both articles, the authors refer to the “dissociative” effects of ketamine. Corssen and Domino 3 originally used the term “dissociative” in 1966 to describe “patients and subjects who, during recovery from CI-581 [ketamine], felt as though they were in outer space, or had no arms or legs.” This term has been used ever since, although we know considerably more about the subjective effects of ketamine than we did in the 1960s.…”

Section: To the Editormentioning

confidence: 99%

Ketamine Pharmacodynamics Entangled: Comment

Bowdle

Sackett²,

Strassman³

et al. 2022

Anesthesiology

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Section: To the Editormentioning

confidence: 99%

Ketamine Pharmacodynamics Entangled: Comment

Bowdle

Sackett²,

Strassman³

et al. 2022

Anesthesiology

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“…Importantly, apart from producing its dose-dependent desired effects, ketamine produces unwanted psychedelic effects that limit dosing recommendations as well as patient compliance. Ketamine is within the class of drugs termed psychoplastogens, a group of drugs that promote synaptic cross-talk in the cortex through rewiring of neurocircuitry ( 3 , 4 ). Ketamine and the other psychoplastogens produce mind-altering effects that are highly associated with their desired effects ( 5 , 6 ).…”

mentioning

confidence: 99%

Editorial: Ketamine for treatment of acute and chronic pain: The relationship of mechanism and exposure to therapeutic outcome

Dahan¹,

Henthorn²

2022

Front. Pain Res.

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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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Ketamine Analgesia and Psychedelia: Can We Dissociate Dissociation?

Cited by 8 publications

References 13 publications

Ketamine Pharmacodynamics Entangled: Comment

Ketamine Pharmacodynamics Entangled: Comment

Editorial: Ketamine for treatment of acute and chronic pain: The relationship of mechanism and exposure to therapeutic outcome

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

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