Esketamine-Induced Dissociation: A Case Report

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• Esketamine, the S-enantiomer of ketamine, offers a novel non-monoaminergic approach for treatment-resistant depression (TRD).
• While its antidepressant efficacy is recognized, understanding its full safety profile, including rare adverse events, is crucial.

Purpose of the Study:

• To report a rare case of severe dissociative and hallucinogenic-like phenomena experienced by a patient undergoing esketamine treatment for TRD.
• To highlight the importance of considering pronounced dissociation as a potential adverse event associated with esketamine therapy.

Main Methods:

• Case report detailing the clinical presentation and experience of a 41-year-old female patient with TRD.
• Review of the patient's response to esketamine and the subsequent adverse event.

Main Results:

• The patient achieved significant improvement in depressive symptoms with esketamine treatment.
• Despite therapeutic benefits, the patient experienced a severe dissociative episode with hallucinogenic-like phenomena.

Conclusions:

• Esketamine's efficacy in TRD is notable, but its potential for severe dissociative side effects requires careful consideration by clinicians and researchers.
• Informed prescribing of esketamine necessitates a comprehensive understanding of its safety profile to optimize patient care and therapeutic outcomes.