Subanesthetic Doses of Ketamine Stimulate Psychosis in Schizophrenia (original) (raw)

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• Published: 01 August 1995

Neuropsychopharmacology volume 13, pages 9–19 (1995)Cite this article

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Abstract

We administered ketamine to schizophrenic individuals in a double-blind, placebo-controlled design using a range of subanesthetic doses (0.1, 0.3, and 0.5 mg/kg) to evaluate the nature, dose characteristics, time course, and neuroleptic modulation of N-methyl-D-aspartate (NMDA) antagonist action on mental status in schizophrenia. Ketamine induced a dose-related, short (< 30 minutes) worsening in mental status in the haloperidol-treated condition, reflected by a significant increase in BPRS total score for the 0.3 mg/kg (p =. 005) and 0.5 mg/kg (p =. 01) challenges. Positive symptoms (hallucinations, delusions, thought disorder), not negative symptoms accounted for these changes. These ketamine-induced psychotic symptoms were strikingly reminiscent of the subject's symptoms during active episodes of their illness. Results from six patients who were retested in the same design after being neuroleptic-free for 4 weeks failed to indicate that haloperidol blocks ketamine-induced psychosis. Several subjects evidenced delayed or prolonged (8–24 hours) psychotomimetic effects such as worsening of psychosis with visual hallucinations. These data suggest that antagonism of NMDA-sensitive glutamatergic transmission in brain exacerbates symptoms of schizophrenia.

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Authors and Affiliations

1. From the Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
   Adrienne C Lahti MD, David LaPorte Ph.D & Carol A Tamminga MD
2. The Department of Psychology, University of Maryland-Baltimore Country, Baltimore, MD
   David LaPorte Ph.D
3. The Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD
   Bettylou Koffel MD

Authors

1. Adrienne C Lahti MD
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2. Bettylou Koffel MD
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3. David LaPorte Ph.D
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4. Carol A Tamminga MD
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Lahti, A., Koffel, B., LaPorte, D. et al. Subanesthetic Doses of Ketamine Stimulate Psychosis in Schizophrenia.Neuropsychopharmacol 13, 9–19 (1995). https://doi.org/10.1016/0893-133X(94)00131-I

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• Received: 08 June 1994
• Revised: 23 November 1994
• Accepted: 12 December 1994
• Published: 01 August 1995
• Issue Date: 01 August 1995
• DOI: https://doi.org/10.1016/0893-133X(94)00131-I

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