Effect of ketamine dose on self-rated dissociation in patients with treatment refractory anxiety disorders
Cameron Castle, Andrew Gray, Shona Neehoff, Paul Glue
Journal of Psychopharmacology October 1, 2017 DOI: 10.1177/0269881117725685 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary analysis of a randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 18 |
| Population | Patients with treatment-resistant anxiety |
| Interventions | Ketamine Midazolam |
| Dose | 0.25–1 mg/kg |
| Topics | Anxiety Esketamine Ketamine |
| Citations | 20 |
| Key findings | The CADSS is an internally consistent instrument for evaluating ketamine-induced dissociation in patients with treatment-resistant anxiety, though it does not capture thought disorder. |
Abstract
Patients receiving ketamine for refractory depression and anxiety report dissociative symptoms in the first 60 min post-dose. The most commonly used instrument to assess this is the Clinician-Administered Dissociative States Scale (CADSS), developed based on the assessment of patients with dissociative symptoms. Its psychometric properties for ketamine-induced dissociation have not been reported. We evaluated these from a study using 0.25–1 mg/kg ketamine and midazolam (as an active control) in 18 patients with treatment-resistant anxiety. Dissociation ratings were increased by ketamine in a dose-dependent manner. In contrast, midazolam showed no effect on ratings of dissociation. For individual CADSS items, the magnitude of change and the ketamine dose at which changes were observed were not homogenous. The Cronbach alpha for the total scale was high (0.937), with acceptable item-rest correlations for almost all individual items. Purposefully removing items to maximise alpha did not lead to meaningful improvements. Acceptable internal consistency was still observed after removing items which lacked evidence of responsiveness at lower doses. The high Cronbach alpha values identified in this study suggests that the CADSS is an internally consistent instrument for evaluating ketamine-induced dissociation in clinical trials in anxiety, although it does not capture symptoms such as thought disorder.
Comparable studies
Other randomized controlled trials on ketamine for anxiety, most cited first.
Citations in the library
Cited by 12
- Ketamine for the treatment of mental health and substance use disorders: comprehensive systematic review BJPsych Open December 23, 2021
- Reconsidering "dissociation" as a predictor of antidepressant efficacy for esketamine. Psychopharmacology April 1, 2023
- Trait dissociation as a predictor of induced dissociation by ketamine or esketamine in treatment-resistant depression: Secondary analysis from a randomized controlled trial. Journal of Psychiatric Research May 8, 2021
- KETAMINE AS A POSSIBLE MODERATOR OF HYPNOTIZABILITY: A Feasibility Study International Journal of Clinical and Experimental Hypnosis June 1, 2018
- Dissociation after ketamine dosing: Is the CADSS fit for purpose? Journal of Affective Disorders December 1, 2017
and 7 more in the library
Cites 9
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013
- Measurement of dissociative states with the Clinician‐Administered Dissociative States Scale (CADSS) Journal of Traumatic Stress 1998
- Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder JAMA Psychiatry April 16, 2014
- A Double-Blind, Randomized, Placebo-Controlled, Dose-Frequency Study of Intravenous Ketamine in Patients With Treatment-Resistant Depression American Journal of Psychiatry April 8, 2016
- Ketamine's dose-related effects on anxiety symptoms in patients with treatment refractory anxiety disorders. Journal of Psychopharmacology October 2017
and 4 more in the library