Investigators: David S. Mathai, Matthew J.Meyer, Eric A.Storch, Thomas R. Kosten
Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, Houston, TX, United States
Baylor College of Medicine, Department of Pharmacology, Houston, TX, United States
Baylor College of Medicine, Department of Neuroscience, Houston, TX, United States
Received 14 September 2019, Revised 11 December 2019, Accepted 13 December 2019, Available online 14 December 2019.
The Relationship Between Subjective Effects Induced by a Single Dose of Ketamine and Treatment Response in Patients With Major Depressive Disorder: A Systematic Review.
Journal of Affective Disorders
Volume 264, 1 March 2020, Pages 123-129
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.