Acute psychoactive effects of intravenous ketamine during treatment of mood disorders: Analysis of the Clinician Administered Dissociative State Scale.
Gerrit I Van Schalkwyk, Samuel T. Wilkinson, Larry Davidson, Wendy K Silverman, Gerard Sanacora
Journal of Affective Disorders February 2018 DOI: 10.1016/j.jad.2017.09.023 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Exploratory factor analysis with qualitative interviews Peer reviewed |
|---|---|
| Sample size | 110 |
| Population | Individuals with mood disorders, predominantly major depressive disorder, undergoing intravenous ketamine infusion |
| Intervention | Ketamine |
| Measures | Clinician Administered Dissociative State Scale (CADSS) |
| Topics | Ketamine Philosophy of mind Esketamine |
| Keywords | Antidepressant Cadss Dissociative |
| Key findings | The CADSS partially captures ketamine's acute psychoactive effects: mean total score was low at 7.7 (SD 9.2), Cronbach's alpha was 0.74, five items correlated poorly with the total, and factor analysis yielded a one-factor solution of 16 items, mostly perceptual disturbances. Patient narratives also identified disinhibition and a sense of peace, which the CADSS does not capture. |
Abstract
Ketamine has rapid-acting antidepressant effects. Frequently, ketamine administration also causes acute psychoactive effects - in trials, these effects are commonly measured using the Clinician Administered Dissociative State Scale (CADSS). However, the CADSS was not designed for this specific purpose, having been validated in other clinical contexts, and anecdotally does not appear to fully capture ketamine's acute psychoactive effects. Data were obtained from 110 individuals with mood disorders (predominantly major depressive disorder) who underwent intravenous ketamine infusion. An exploratory factor analysis (EFA) was performed on the CADSS, along with assessment of internal consistency. Qualitative methods were used to conduct in-depth interviews with a subset of these participants to identify key features of the acute ketamine experience, including aspects that may not be captured by the CADSS. The mean total score of the CADSS was low at 7.7 (SD 9.2). Analysis of internal consistency showed a Cronbach's alpha of 0.74. Five CADSS items had low correlations with the total score. EFA lead to a one-factor solution containing 16 items. Five of the six highest loading items involved perceptual disturbances, either of time or sensation. Qualitative analyses of 10 patient narratives revealed two phenomena not captured on the CADSS: disinhibition and a sense of peace. This study was by limited by the absence of other ratings of the participants' experience. Findings suggest that the CADSS partially captures the acute effects of ketamine administration. Further research may seek to validate a revised version of the CADSS that more accurately measures these effects.
Comparable studies
Other qualitative studies on ketamine, 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
- Features of Dissociation Differentially Predict Antidepressant Response to Ketamine in Treatment-Resistant Depression Journal of Affective Disorders February 17, 2018
- Ketamine and Serotonergic Psychedelics: Common Mechanisms Underlying the Effects of Rapid-Acting Antidepressants The International Journal of Neuropsychopharmacology November 16, 2020
- Characterizing brain dynamics during ketamine-induced dissociation and subsequent interactions with propofol using human intracranial neurophysiology Nature Communications March 29, 2023
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Cites 16
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- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Science August 19, 2010
- NMDAR inhibition-independent antidepressant actions of ketamine metabolites Nature April 24, 2016
- Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial American Journal of Psychiatry August 28, 2013
- A Randomized Add-on Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Bipolar Depression Archives of General Psychiatry August 1, 2010
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