One of the most famous side effects of ketamine is dissociation. Dissociation is a temporary mental state in which a person ‘detaches’ from the surroundings, meaning a person becomes less aware of what is actually around one and starts to feel disconnected from one’s body.
The CADSS scale is an instrument used by clinicians to measure the degree of dissociation during ketamine infusions. It looks at symptoms such as:
- things are in slow motion or seem unreal
- feeling separated from reality
- feeling as if looking at things from outside the body
- feeling like you are a spectator or like you are observed
- objects looking different
- colors seeming brighter or duller than usual
- time slowing down or speeding up
- having tunnel vision or seeing things through a fog
- losing track of time or what is happening in the environment
- feeling as though your body has changed
These symptoms may feel uncomfortable for some people. It is important to remember that if you do experience dissociation during a ketamine infusion, it is temporary. Additionally, patients typically find that the first infusion makes them feel the strangest, and that the dissociative effects decrease in subsequent infusions. Most people find ketamine infusions to be quite pleasant and relaxing, even if they are experiencing dissociative symptoms. If someone is experiencing these symptoms and finds it unpleasant or frightening, there are ways to mitigate it.
At Principium Psychiatry, we have found that our method of administering ketamine makes the experience much smoother. We have found that under our ketamine administration protocol, patients report fewer dissociative symptoms as well as fewer symptoms such as dizziness, light-headedness, and nausea, than they experienced at other centers. In addition, if dissociative symptoms are causing discomfort, medication can be administered during the infusion to limit them.
In terms of linking the occurrence of dissociation and the efficacy of ketamine as an antidepressant, studies are conflicting. Some studies have found that patients who experience greater dissociation during ketamine infusions have greater antidepressant benefit. Other studies have found no correlation between dissociative symptoms and antidepressant effect. Simply put, the science is not settled.
For this reason, at Principium Psychiatry, we believe the main goal during ketamine infusions is to make patients feel as comfortable and relaxed as possible. The treatment will only be effective if it is well tolerated and patients look forward to returning for their infusions. It is therefore important to speak up to your ketamine provider if you are experiencing symptoms with which you are uncomfortable.
At Principium Psychiatry, ketamine infusions for depression in NYC are offered in a comfortable, private setting. Our ketamine infusions in Manhattan, near Columbus Circle, offer a convenient and private location for depression treatment, accessible to the Tristate Area. We are near Penn Station as well as all major subway lines.
In addition to ketamine infusions, Principium Psychiatry offers Transcranial Magnetic Stimulation (TMS). Principium Psychiatry TMS in NYC is a safe, medication free alternative to antidepressants. Please read more about TMS and Ketamine on our website and call Principium Psychiatry at 212-335-0236 with any questions.