The relationship between subjective effects induced by a single dose of ketamine and treatment response in patients with major depressive disorder: A systematic review.
David S. Mathai, Matthew Meyer, Eric A. Storch, Thomas R Kosten
Journal of Affective Disorders March 1, 2020 DOI: 10.1016/j.jad.2019.12.023 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Patients with major depressive disorder receiving ketamine treatment |
| Intervention | Ketamine |
| Measures | Clinician-Administered Dissociative States Scale (CADSS), Brief Psychiatric Rating Scale (BPRS), 5-Dimensional Altered States of Consciousness Rating Scale (5D-ASC), Montgomery-Åsberg Depression Rating Scale (MADRS) |
| Topics | Depression Ketamine Esketamine |
| Keywords | Dissociation Hallucinogen Psychedelic Psychotomimetic |
| Key findings | Across 8 included studies, ketamine's dissociative and psychotomimetic effects correlated with changes in depression scores in 37.5% of studies: two of five CADSS studies showed significant negative correlations, one of six BPRS studies showed a correlation, and the single 5D-ASC study found none. The authors conclude that most studies did not examine this relationship and that future research should consider it, as it appears important for MDMA and psilocybin therapies. |
Abstract
The relationship between ketamine's hallucinogenic- and dissociative-type effects and antidepressant mechanism of action is poorly understood. This paper reviewed the correlation between subjective effects defined by various psychometric scales and observed clinical outcomes in the treatment of patients with Major Depressive Disorder (MDD). Based on PRISMA guidelines, we reviewed the dissociative and psychotomimetic mental state induced with ketamine during MDD treatment. Our selected studies correlated depression rating with validated scales collected at regular intervals throughout the study period such as the Clinician-Administered Dissociative States Scale (CADSS), Brief Psychiatric Rating Scale (BPRS), and the 5-Dimensional Altered States of Consciousness Rating Scale (5D-ASC). We excluded studies with bipolar depression or with repeated dosing and no single-dose phase. We included 8 of 556 screened reports. Two of five CADSS studies found significant negative correlations between increases in CADSS scores and depression scores. One of six BPRS studies demonstrated correlations between BPRS scores and depression scores. The 5D-ASC's one study found no correlation with the MADRS. Ketamine's dissociative and psychotomimetic effects were correlated with depression changes in 37.5% of studies, but most studies did not examine this relationship and future studies should consider this association since it appears important for MDMA and psilocybin therapies.
Comparable studies
Other systematic reviews and meta-analyses on ketamine for depression, most cited first.
Citations in the library
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- Psychedelic Treatments for Psychiatric Disorders: A Systematic Review and Thematic Synthesis of Patient Experiences in Qualitative Studies CNS Drugs August 17, 2020
- Ketamine and Serotonergic Psychedelics: Common Mechanisms Underlying the Effects of Rapid-Acting Antidepressants The International Journal of Neuropsychopharmacology November 16, 2020
- Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy Frontiers in Neuroscience September 20, 2021
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Cites 42
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- Measurement of dissociative states with the Clinician‐Administered Dissociative States Scale (CADSS) Journal of Traumatic Stress 1998
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