{
  "id": 8587759,
  "title": "Esketamine-induced dissociation is tied to better outcomes in treatment-resistant depression",
  "url": "https://urgent.news/2026/09/20/esketamine-induced-dissociation-is-tied-to-better-outcomes-in",
  "topic": "health",
  "section": "Health & Medicine",
  "published": "2026-09-20T02:00:47.000Z",
  "source": {
    "name": "PsyPost",
    "slug": "psypost",
    "url": "https://www.psypost.org/esketamine-induced-dissociation-is-tied-to-better-outcomes-in-treatment-resistant-depression/"
  },
  "original_language": "en",
  "account": "A recent study published in the Journal of Psychiatric Research suggests that patients who experienced improvement after receiving subcutaneous esketamine for treatment-resistant depression reported higher levels of dissociation, particularly feelings of the world seeming unreal or distant, compared to patients who did not respond. Treatment-resistant depression refers to a condition where depression persists despite at least two adequate trials of standard antidepressants. Esketamine, a form of ketamine, has gained attention as a potential treatment for such cases. Ketamine, originally developed as an anesthetic, has been found to produce rapid changes in depressive symptoms and can also cause temporary alterations in consciousness. Some patients describe feeling separated from their body or thoughts, while others report their surroundings appearing unreal, distant, or dreamlike – experiences generally termed as dissociation. The exact relationship between dissociation and the drug's antidepressant action remains a subject of debate. This study examined data from an open-label clinical trial conducted at Onofre Lopes University Hospital in Brazil, led by Kaike Thiê da C. Gonçalves from the University of São Paulo. The trial involved 30 adults who received weekly subcutaneous esketamine treatments over eight sessions. Of the enrolled participants, 23 completed all sessions and were included in the analysis. The participants were predominantly female (15) and male (8), with an average age of 34.3 years. Initially, each participant received 0.5 milligrams of esketamine per kilogram of body weight, with the dose potentially increased to 0.75 or 1 milligram per kilogram if depressive symptoms did not improve by at least 50%. The researchers measured depression both before each session and one week after the final session, as well as dissociation 40 minutes after each dose using a specific questionnaire. Overall, 12 participants were classified as treatment responders, meaning their depression scores dropped by at least 50%. These responders exhibited higher overall dissociation scores, including more instances of derealization (feeling the world is unreal), depersonalization (feeling detached from oneself), and amnesia (memory gaps) compared to the 11 nonresponders. Importantly, dissociation levels remained relatively stable across the treatment sessions, and no significant correlation was found between dissociation and improvements in depression scores. The researchers concluded that dissociative experiences, particularly derealization, may be clinically relevant indicators of antidepressant outcomes. However, they stressed that these findings are preliminary and could help inform future research into the potential relevance of different aspects of altered consciousness to treatment outcomes. The study had several limitations, including the absence of a placebo group, lack of blinding, and the failure to account fully for other medications, psychiatric conditions, or psychotherapy outside the treatment. Additionally, the researchers increased the dose for patients who were not responding adequately, which might partly account for the higher dissociation scores due to increased drug exposure rather than a true biological marker of clinical improvement.",
  "summary": "Patients with treatment-resistant depression who experienced feelings of unreality during subcutaneous esketamine therapy were more likely to see their depression symptoms improve, suggesting dissociation may be tied to the drug's effectiveness rather than just a side effect.",
  "key_points": [
    "Esketamine, a ketamine form, induces dissociative experiences like feeling unreal or distant.",
    "Higher dissociation scores in responders, but no direct correlation with depression improvement."
  ],
  "editors_take": "This study suggests that feelings of dissociation, particularly a sense of unreality, may be a clinically relevant indicator of successful treatment outcomes for patients with treatment-resistant depression receiving esketamine.",
  "illustration": null,
  "coverage": {
    "outlets": 1,
    "also_reported_by": []
  },
  "ai_generated": true,
  "disclaimer": "Summaries, key points and the editor’s take are written by software from other outlets’ reporting and may contain errors — always check the linked original."
}