CASE REPORT article
Front. Psychiatry
Sec. Psychopharmacology
This article is part of the Research TopicBridging the Gap: An Interdisciplinary Perspective on Ketamine in Psychiatric Disorders - Volume IIIView all 6 articles
Case report: a possible association between significant dissociations after esketamine treatment and histrionic personality disorder
Provisionally accepted
- 1Riga Stradins Universitate Medicinas Fakultate, Riga, Latvia
- 2Riga Stradiņš University, Riga, Latvia
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Dissociation is a complex and transdiagnostic phenomenon defined as a disruption of, or discontinuity in, the normal, subjective integration of one or more aspects of psychological functioning. Dissociation has been identified as one of the most frequently occurring adverse effects associated with the use of esketamine nasal sprays. Individuals with high trait dissociation may be at a higher risk of experiencing an induced dissociative state and a significantly higher risk of experiencing severe induced dissociation. High esketamine-induced dissociation may act as a predictor of optimal therapeutic response, rather than solely an adverse effect. This case report describes an unusually intense and persistent dissociative reaction in a patient with histrionic personality disorder (HPD) undergoing esketamine therapy. The patient's marked dissociation upon treatment initiation raises the possibility that certain personality traits characteristic of HPD may heighten vulnerability to esketamine-induced dissociation. By explicitly examining a potential link between HPD and dissociation severity, this case highlights the importance of identifying patient-level factors that may amplify dissociative responses. Such knowledge has practical clinical implications for risk stratification, patient education regarding expected side effects, ensuring increased attention during the procedure.
Keywords: Depression, dissociations, Esketamine, Histrionic personality, Treatment
Received: 15 Jul 2025; Accepted: 05 Dec 2025.
Copyright: © 2025 Savica, Sile and Taube. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Māris Taube
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