Adjunctive music improves the tolerability of intravenous ketamine for bipolar depression
Kyle T. Greenway, Nicolas Garel, Nathalie Goyette, Gustavo Turecki, S. Richard-Devantoy
International Clinical Psychopharmacology April 23, 2021 DOI: 10.1097/yic.0000000000000363 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Patients with bipolar 1 disorder and severe depression |
| Interventions | Intravenous ketamine Adjunctive music |
| Duration | Six ketamine infusions |
| Topics | Depression Esketamine Ketamine |
| Citations | 12 |
| Key findings | Adjunctive music diminished distress from ketamine-induced dissociation in two patients with bipolar 1 depression, and both achieved remission after six infusions. |
Abstract
Intravenous ketamine is an effective treatment of bipolar depression. One of its most important side-effects is a transient altered state of consciousness commonly referred to as dissociation. These states can be anxiety-provoking, distressing and even treatment-limiting, warranting research into mitigation strategies. In this article, we present two cases that demonstrate the potential of adjunctive music to diminish the distress associated with ketamine-induced dissociation – though not necessarily its degree – in bipolar 1 disorder. Both patients suffering from severe depression underwent their first ketamine infusion without music and opted for music with subsequent infusions. They reported that music significantly improved the tolerance of their dissociative symptoms, thereby reducing distress and facilitating subsequent treatments. Both patients achieved remission from their highly treatment-resistant depressive episodes following six ketamine infusions. This is the first report of music’s benefits on ketamine for bipolar 1 depression, though there is precedence in the scientific literature on ‘psychedelics’ where the use of music in combination with medication-induced altered states has been studied. The principles regarding music selection that have resulted from this paradigm may be applicable to the use of ketamine in unipolar and bipolar depression. The optimal use of music with ketamine warrants further research.
Comparable studies
Other case reports and case series on ketamine for depression, most cited first.