ArticlePsychopharmacology2023
Reconsidering "dissociation" as a predictor of antidepressant efficacy for esketamine.
Article in Psychopharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Pooled it
- Ketamine-induced altered states of consciousness: a systematic review of implications for therapeutic outcomes in psychiatric practices.European archives of psychiatry and clinical neuroscience · 2025Pooled it
- A transdiagnostic systematic review and meta-analysis of ketamine's anxiolytic effects.Journal of psychopharmacology (Oxford, England) · 2023Pooled it
- Ketamine reduces the neural distinction between self- and other-produced affective touch: a randomized double-blind placebo-controlled study.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024Trial
- Acute Dissociation and Ketamine's Antidepressant and Anti-Suicidal Ideation Effects in a Midazolam-Controlled Trial.The international journal of neuropsychopharmacology · 2024Trial
- Narrative Experiences of Esketamine-Induced Dissociation in Patients with Treatment-Resistant Depression: A Qualitative Exploratory Study.Brain sciences · 2026Article
- Patients' Voices on Ketamine for Treatment-Resistant Depression: A Narrative Review of Qualitative Perspectives.Journal of clinical medicine · 2025Review
- Advancing past ketamine: emerging glutamatergic compounds for the treatment of depression.European archives of psychiatry and clinical neuroscience · 2025Review
- Esketamine use in real-world clinical practice in patients with treatment-resistant depression.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Fine-tuning of dopamine receptor signaling with aripiprazole counteracts ketamine's dissociative action, but not its antidepressant effect.Translational psychiatry · 2025Article
- Personalized use of ketamine and esketamine for treatment-resistant depression.Translational psychiatry · 2024Review
- Psychometric properties of the 23-Item Clinician Administered Dissociative States Scale (CADSS) in a psychological trauma population.Journal of affective disorders · 2024Article
- At-home, telehealth-supported ketamine treatment for depression: Findings from longitudinal, machine learning and symptom network analysis of real-world data.Journal of affective disorders · 2024Article
- Experiences of Awe Mediate Ketamine's Antidepressant Effects: Findings From a Randomized Controlled Trial in Treatment-Resistant Depression.Biological psychiatry global open science · 2024Article
- Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies.Journal of medical Internet research · 2024Article
- Ketamine, Dissociation, and Depression: What Is "Special" About Ketamine? (Revisited).The international journal of neuropsychopharmacology · 2024Article
- Acute Subjective Experiences of Intravenous Ketamine Therapy Among Medically Hospitalized Patients with Alcohol Use Disorder.Psychedelic medicine (New Rochelle, N.Y.) · 2024Article
- Facts and myths about use of esketamine for treatment-resistant depression: a narrative clinical review.Frontiers in psychiatry · 2024Review
- Double-Blind Comparison of the Two Hallucinogens Dextromethorphan and Psilocybin: Experience-Dependent and Enduring Psychological Effects in Healthy Volunteers.Psychedelic medicine (New Rochelle, N.Y.) · 2023Article
- Central nervous system-related safety and tolerability of add-on ketamine to standard of care treatment in treatment-resistant psychotic depression in patients with major depressive disorder and bipolar disorder.Frontiers in neuroscience · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleThe relationship between subjective drug experience and antidepressant outcomes for ketamine derivatives is poorly understood but of high clinical relevance. Esketamine is the patented (S)-enantiomer of ketamine and has regulatory approval for psychiatric applications.
objectivesWe examined the relationship between acute dissociation, as measured by the Clinician-Administered Dissociative States Scale (CADSS), and antidepressant efficacy, as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS), for esketamine across the 4-week induction phase of treatment.
methodsThis post hoc analysis combined data (N = 576) from the TRANSFORM-1 and TRANSFORM-2 clinical trials of esketamine for treatment-resistant depression. Linear mixed models were performed using total MADRS score as the outcome variable with the following independent variables: baseline MADRS score, treatment condition × time interaction, and CADSS × time interaction. To assess whether initial dissociation predicted rapid antidepressant benefit with esketamine, a separately planned regression was performed with day 2 MADRS as the outcome variable with the following dependent variables: baseline MADRS, treatment condition, and day 1 CADSS.
resultsThe linear mixed model did not show any effect of a CADSS × time interaction (p = 0.7). Looking solely at the effect of day 1 CADSS on day 2 MADRS revealed that each additional CADSS point was associated with a - .04 [95% CI - .08, - .002] (p = .04) decrease in MADRS score.
conclusionsWe found no evidence of a clinically significant positive or negative association between dissociation and antidepressant effect for esketamine. Our findings suggest that subsequent inquiry in this area will benefit from improved characterization of drug experiences relevant to therapeutic outcomes.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.