A qualitative and quantitative account of patient's experiences of ketamine and its antidepressant properties.


Journal

Journal of psychopharmacology (Oxford, England)
ISSN: 1461-7285
Titre abrégé: J Psychopharmacol
Pays: United States
ID NLM: 8907828

Informations de publication

Date de publication:
Aug 2021
Historique:
pubmed: 31 3 2021
medline: 3 2 2022
entrez: 30 3 2021
Statut: ppublish

Résumé

Ketamine is central to one of the most rapidly growing areas of neuroscientific research into novel treatments for depression. Limited research has indicated that the psychedelic properties of ketamine may play a role in its antidepressant effects. The aim of the current study was to explore the psychedelic experiences and sustained impact of ketamine in major depressive disorder. In the current study, ketamine (0.44 mg/kg) was administered to 32 volunteers with major depressive disorder in a crossover design with the active-placebo remifentanil, in a magnetic resonance imaging (MRI) environment. The 11-dimension altered states of consciousness questionnaire and individual qualitative interviews were used to capture the acute psychedelic experience. The Montgomery-Asberg Depression Rating Scale and further interviewing explored lasting effects. The second qualitative interview took place ⩾3 weeks post-ketamine. Greater antidepressant response (reduction in Montgomery-Asberg Depression Rating Scale at 24 h) correlated with the 11-dimension altered states of consciousness dimensions: spirituality, experience of unity, and insight. The first qualitative interview revealed that all participants experienced perceptual changes. Additional themes emerged including loss of control and emotional and mood changes. The final interview showed evidence of a psychedelic afterglow, and changes to perspective on life, people, and problems, as well as changes to how participants felt about their depression and treatments. The current study provides preliminary evidence for a role of the psychedelic experience and afterglow in ketamine's antidepressant properties. Reflexive thematic analysis provided a wealth of information on participants' experience of the study and demonstrated the psychedelic properties of ketamine are not fully captured by commonly used questionnaires.

Sections du résumé

BACKGROUND BACKGROUND
Ketamine is central to one of the most rapidly growing areas of neuroscientific research into novel treatments for depression. Limited research has indicated that the psychedelic properties of ketamine may play a role in its antidepressant effects.
AIM OBJECTIVE
The aim of the current study was to explore the psychedelic experiences and sustained impact of ketamine in major depressive disorder.
METHODS METHODS
In the current study, ketamine (0.44 mg/kg) was administered to 32 volunteers with major depressive disorder in a crossover design with the active-placebo remifentanil, in a magnetic resonance imaging (MRI) environment. The 11-dimension altered states of consciousness questionnaire and individual qualitative interviews were used to capture the acute psychedelic experience. The Montgomery-Asberg Depression Rating Scale and further interviewing explored lasting effects. The second qualitative interview took place ⩾3 weeks post-ketamine.
RESULTS RESULTS
Greater antidepressant response (reduction in Montgomery-Asberg Depression Rating Scale at 24 h) correlated with the 11-dimension altered states of consciousness dimensions: spirituality, experience of unity, and insight. The first qualitative interview revealed that all participants experienced perceptual changes. Additional themes emerged including loss of control and emotional and mood changes. The final interview showed evidence of a psychedelic afterglow, and changes to perspective on life, people, and problems, as well as changes to how participants felt about their depression and treatments.
CONCLUSIONS CONCLUSIONS
The current study provides preliminary evidence for a role of the psychedelic experience and afterglow in ketamine's antidepressant properties. Reflexive thematic analysis provided a wealth of information on participants' experience of the study and demonstrated the psychedelic properties of ketamine are not fully captured by commonly used questionnaires.

Identifiants

pubmed: 33781107
doi: 10.1177/0269881121998321
doi:

Substances chimiques

Antidepressive Agents 0
Ketamine 690G0D6V8H
Remifentanil P10582JYYK

Types de publication

Comparative Study Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

946-961

Auteurs

Rachael L Sumner (RL)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Emme Chacko (E)

Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.

Rebecca McMillan (R)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Meg J Spriggs (MJ)

Centre for Psychedelic Research, Imperial College London, London, UK.

Christie Anderson (C)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

James Chen (J)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Amelia French (A)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

SungHun Jung (S)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Akshaya Rajan (A)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Gemma Malpas (G)

Department of Anaesthesia and Perioperative Medicine, Auckland District Health Board, Auckland, New Zealand.

John Hay (J)

Department of Anaesthesia and Perioperative Medicine, Auckland District Health Board, Auckland, New Zealand.

Rhys Ponton (R)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Suresh D Muthukumaraswamy (SD)

School of Pharmacy, University of Auckland, Auckland, New Zealand.

Frederick Sundram (F)

Department of Psychological Medicine, University of Auckland, Auckland, New Zealand.

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Classifications MeSH