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Abstract

Objective:

The authors sought to assess the prosocial, entactogen effects of ketamine.

Methods:

Pleasure from social situations was assessed in a sample of participants with treatment-resistant depression from randomized, double-blind, placebo-controlled studies, using four items of the Snaith-Hamilton Pleasure Scale (SHAPS) at five time points over 1 week following treatment with ketamine (0.5 mg/kg intravenously) or placebo. The primary endpoint was postinfusion self-reported pleasure on the four SHAPS items pertaining to social situations, including the item on helping others, between the ketamine and placebo groups. In a rodent experiment, the impact of ketamine on helping behavior in rats was assessed using the harm aversion task. The primary endpoint was a reduction in lever response rate relative to baseline, which indicated the willingness of rats to forgo obtaining sucrose to help protect their cage mate from electric shock.

Results:

Relative to placebo, ketamine increased ratings of feeling pleasure from being with family or close friends, seeing other people’s smiling faces, helping others, and receiving praise, for 1 week following treatment. In the rodent experiment, during the harm aversion task, ketamine-treated rats maintained lower response rates relative to baseline to a greater extent than what was observed in vehicle-treated rats for 6 days posttreatment and delivered fewer shocks overall.

Conclusions:

In patients with treatment-resistant depression, ketamine treatment was associated with increased pleasure from social situations, such as feeling pleasure from helping others. Ketamine-treated rats were more likely to protect their cage mate from harm, at the cost of obtaining sucrose. These findings suggest that ketamine has entactogen effects.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 815 - 823
PubMed: 38982828

History

Received: 30 November 2023
Revision received: 19 February 2024
Revision received: 17 March 2024
Accepted: 4 April 2024
Published online: 10 July 2024
Published in print: September 01, 2024

Keywords

  1. Ketamine/Esketamine
  2. Depressive Disorders
  3. Antidepressants
  4. Entactogens

Authors

Details

Evan M. Hess, Ph.D.
Department of Psychiatry (Hess, Hutchinson, Gould), Department of Neurobiology (Gould), and Department of Pharmacology (Gould), University of Maryland School of Medicine, Baltimore; Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, Md. (Greenstein, Zarate); Baltimore Veterans Affairs Medical Center, Veterans Affairs Maryland Health Care System, Baltimore (Gould).
Dede K. Greenstein, Ph.D.
Department of Psychiatry (Hess, Hutchinson, Gould), Department of Neurobiology (Gould), and Department of Pharmacology (Gould), University of Maryland School of Medicine, Baltimore; Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, Md. (Greenstein, Zarate); Baltimore Veterans Affairs Medical Center, Veterans Affairs Maryland Health Care System, Baltimore (Gould).
Olivia L. Hutchinson, B.S.
Department of Psychiatry (Hess, Hutchinson, Gould), Department of Neurobiology (Gould), and Department of Pharmacology (Gould), University of Maryland School of Medicine, Baltimore; Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, Md. (Greenstein, Zarate); Baltimore Veterans Affairs Medical Center, Veterans Affairs Maryland Health Care System, Baltimore (Gould).
Carlos A. Zarate, Jr., M.D.
Department of Psychiatry (Hess, Hutchinson, Gould), Department of Neurobiology (Gould), and Department of Pharmacology (Gould), University of Maryland School of Medicine, Baltimore; Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, Md. (Greenstein, Zarate); Baltimore Veterans Affairs Medical Center, Veterans Affairs Maryland Health Care System, Baltimore (Gould).
Todd D. Gould, M.D. [email protected]
Department of Psychiatry (Hess, Hutchinson, Gould), Department of Neurobiology (Gould), and Department of Pharmacology (Gould), University of Maryland School of Medicine, Baltimore; Experimental Therapeutics and Pathophysiology Branch, NIMH, Bethesda, Md. (Greenstein, Zarate); Baltimore Veterans Affairs Medical Center, Veterans Affairs Maryland Health Care System, Baltimore (Gould).

Notes

Send correspondence to Dr. Gould ([email protected]).

Competing Interests

Drs. Zarate and Gould are listed as inventors on patents and patent applications related to the pharmacology and use of ketamine metabolites in the treatment of depression, anxiety, anhedonia, neuropathic pain, suicidal ideation, and/or posttraumatic stress disorders. Dr. Zarate has assigned his patent rights to the U.S. government but will share a percentage of any royalties that may be received by the government. Dr. Gould has assigned his patent rights to the University of Maryland, Baltimore, but will share a percentage of any royalties that may be received by the university. The other authors report no financial relationships with commercial interests.

Funding Information

Dr. Hess was supported by NIMH grant T32-MH067533 through the Maryland Psychiatric Research Center. Dr. Gould was supported by NIMH grant R01MH107615 and U.S. Department of Veterans Affairs Merit Awards 1I01BX004062 and 1I01BX006018. Funding for this work was provided in part by the NIMH Intramural Research Program (grant ZIAMH002927).

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