Distinct Roles of Therapeutic Expectations and Dissociative Symptoms in Antidepressant Response During Ketamine Treatment in Routine Care
Willys Cantenys, Zeynep Yoldas, Luc Masset, Alix Romier, Léonie Samion, Marion Imbault, Thai-Moc Tram Tran, Flavia Megda Garcia, Samar Soltani, Martina Marradi, Hanh-Dan Ho, Antoinette Gohier, Chahinaz Doulazmi, Marianne Chesneau, Cécile Jadaan, Joy Bulut, Ndilyam Djonouma, Salma Charradi, Anne Claret Tournier, Philippe Fossati, Liane Schmidt
medRxiv Preprint Server April 23, 2026 preprint DOI: 10.64898/2026.04.23.26351276 via medRxiv
Summary
AI-generated from the abstractKetamine works quickly as an antidepressant but also causes temporary dissociative symptoms. In everyday clinical settings, it is unclear how much of the antidepressant effect comes from patients' expectations versus from the dissociative experience itself, and how these factors relate to changes in depression over time.
Study at a glance
| Characteristics | Observational cohort |
|---|---|
| Intervention | Ketamine |
| Key finding | The respective contributions of therapeutic expectations and dissociative symptoms to antidepressant response, and the directionality of their associations with depressive symptom change, remain poorly characterized. |
Abstract
Background Ketamine is a rapid-acting antidepressant that produces acute dissociative symptoms. In routine care, the respective contributions of therapeutic expectations and dissociative symptoms to antidepressant response, and the directionality of their associations with depressive symptom change, remain poorly characterized.