Dissociation and Antidepressant Response to Subcutaneous Esketamine: A Clinical Study
Journal of Psychiatric Research July 1, 2026 K S de Freitas Goncalves, Vagner Deuel de O Tavares, Fernanda Palhano-Fontes et al.
In patients with treatment-resistant depression receiving up to eight weekly subcutaneous doses of esketamine, those who responded to treatment (≥50% reduction in MADRS scores) showed significantly higher levels of dissociation, particularly derealization, compared with non-responders. Depersonalization and amnesia scores also tended to be higher among responders, though these differences were not statistically significant. The authors suggest that dissociative experiences, especially derealization, may be clinically relevant correlates of antidepressant outcomes, but note that further prospective studies with larger samples and dose-controlled designs are needed before clinical utility can be established.