Entactogen Effects of Ketamine: A Reverse-Translational Study

Am J Psychiatry. 2024 Sep 1;181(9):815-823. doi: 10.1176/appi.ajp.20230980. Epub 2024 Jul 10.

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.

Keywords: Antidepressants; Depressive Disorders; Entactogens; Ketamine/Esketamine.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Animals
  • Cross-Over Studies
  • Depressive Disorder, Treatment-Resistant* / drug therapy
  • Double-Blind Method
  • Excitatory Amino Acid Antagonists / administration & dosage
  • Female
  • Humans
  • Ketamine* / administration & dosage
  • Male
  • Middle Aged
  • Pleasure / drug effects
  • Rats
  • Social Behavior

Substances

  • Excitatory Amino Acid Antagonists
  • Ketamine