Stocker Kurt, Hartmann Matthias, Reissmann Steffen, Kist Andreas, Liechti Matthias E
Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
Chair of Cognitive Science, Department of Humanities, Social and Political Sciences, ETH Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Front Pharmacol. 2022 Jul 25;13:916641. doi: 10.3389/fphar.2022.916641. eCollection 2022.
Cognition that is not dominated by thinking in terms of opposites (opposite diminishing) or by making judgments (non-judging) can be found both in Buddhist/mindfulness contexts and in mental states that are fostered by dissociative psychedelics (-methyl-D-aspartate antagonists) such as ketamine. Especially for the Buddhist/mindfulness case, both opposite diminishing and non-judging have been proposed to relate to mental well-being. Whether ketamine-occasioned opposite diminishing and/or non-judging relate to increased mental well-being in the form of antidepressant response is unknown, and was investigated in the present study. In this open-label outpatient study, the dose level and frequency for the ketamine infusions were adjusted individually in close consultation with the patients suffering from depression with the overall goal to maximize antidepressant benefits-a novel dose regimen that we term . In general, treatment started with an initial series of ketamine infusions with a dosage of 0.5 mg/kg body weight and was then adjusted (usually increased). A possible relationship between ketamine-induced antidepressant benefits and retrospectively reported peri-infusion experiences of opposite diminishing and non-judging was assessed based on a total of 45 ketamine-infusion treatment sessions from 11 different patients suffering from depression. Opposite diminishing and non-judging were measured with the two items from the Altered States of Consciousness Inventory (ASCI) that measure these concepts. Depression was measured with the Beck Depression Inventory (BDI-II). Peri-infusion experiences of both opposite diminishing and non-judging were associated with antidepressant responses confirming our hypothesis. Furthermore, opposite diminishing and non-judging were closely related to one another while relating to antidepressant response in distinguishable ways. Future controlled randomized trials with dissociative and other psychedelics and with a larger number of participants are needed to establish the possible link of psychedelically induced opposite diminishing and non-judging with an antidepressant response more firmly.
在佛教/正念情境以及由解离性迷幻药（如氯胺酮等N-甲基-D-天冬氨酸拮抗剂）所促进的心理状态中，都能发现不受对立思维（对立减弱）或评判（非评判）主导的认知。尤其是在佛教/正念的情形中，对立减弱和非评判都被认为与心理健康有关。氯胺酮引发的对立减弱和/或非评判是否以抗抑郁反应的形式与心理健康改善相关尚不清楚，本研究对此进行了调查。在这项开放标签的门诊研究中，氯胺酮输注的剂量水平和频率会与抑郁症患者密切协商后进行个体化调整，总体目标是使抗抑郁效果最大化——这是一种我们称为 的新型剂量方案。一般来说，治疗从初始的一系列氯胺酮输注开始，剂量为0.5毫克/千克体重，然后进行调整（通常是增加剂量）。基于11名不同抑郁症患者的总共45次氯胺酮输注治疗疗程，评估了氯胺酮诱导的抗抑郁效果与回顾性报告的输注期间对立减弱和非评判体验之间的可能关系。对立减弱和非评判用意识状态改变量表（ASCI）中测量这些概念的两个项目进行测量。抑郁症用贝克抑郁量表（BDI-II）进行测量。输注期间的对立减弱和非评判体验均与抗抑郁反应相关，证实了我们的假设。此外，对立减弱和非评判彼此密切相关，同时以可区分的方式与抗抑郁反应相关。未来需要进行更多参与者的关于解离性和其他迷幻药的对照随机试验，以更牢固地确立迷幻药诱导的对立减弱和非评判与抗抑郁反应之间的可能联系。
