The role of dissociation in ketamine’s antidepressant effects

Summary & key facts

This paper reviews whether the strange, dream-like side effects of ketamine are needed for its fast antidepressant effects. Ketamine can lift mood quickly and it also causes short-term dissociation, where people feel changed awareness of themselves and their surroundings. The current studies do not support the idea that dissociation is required for ketamine to help depression. The authors say more research is needed to study brain signals, biological markers, and psychological effects to understand the link better.

Key facts:

• Ketamine can produce fast antidepressant effects, meaning people can feel mood improvement shortly after treatment.
• Ketamine often causes short-term dissociative effects. That means people report altered awareness and altered perceptions of themselves and their environment.
• Scientists have asked whether those dissociative experiences are necessary for ketamine’s antidepressant effects.
• Based on the studies so far, the literature does not support the conclusion that dissociation is required for ketamine to reduce depressive symptoms.
• The paper examines both immediate and longer-lasting antidepressant responses to ketamine and to other drugs that block a brain receptor sometimes called NMDA.
• The authors call for more research at the molecular level, with biological markers, and on psychological processes to clarify how dissociation and antidepressant response are related.

Abstract

Ketamine produces immediate antidepressant effects and has inspired research into next-generation treatments. Ketamine also has short term dissociative effects, in which individuals report altered consciousness and perceptions of themselves and their environment. However, whether ketamine's dissociative side effects are necessary for its antidepressant effects remains unclear. This perspective examines the relationship between dissociative effects and acute and longer-lasting antidepressant response to ketamine and other N-methyl-D-aspartate (NMDA) receptor antagonists. Presently, the literature does not support the conclusion that dissociation is necessary for antidepressant response to ketamine. However, further work is needed to explore the relationship between dissociation and antidepressant response at the molecular, biomarker, and psychological levels.

Topics

Neuroscience and Neuropharmacology Research Treatment of Major Depression Tryptophan and brain disorders

Categories

Health Sciences Medicine Pharmacology

Tags

Antidepressant Chemistry Dissociation (chemistry) Dissociative Glutamate receptor Hippocampus Internal medicine Ketamine Medicine Neuroscience NMDA receptor Pharmacology Physical chemistry Psychology Receptor

Substances

Ketamine

Conditions & symptoms

Depression PTSD Feeling disconnected from others Sadness or low mood