Rapid reduction of suicidal ideation with transient dissociative and "drunken gait" symptoms after intranasal esketamine, with music intervention: a case report.
Frontiers in psychiatry January 1, 2026 Haihua Tian, Zongfeng Zhang, Yan He et al. 1 citation
A 19-year-old woman with treatment-resistant depression and multiple suicide attempts received two courses of intranasal esketamine. During the first course, she experienced transient dissociative symptoms lasting about 55 minutes, including depersonalization and a 'drunken gait.' Patient-selected music reduced anxiety and disorientation, and prophylactic oxazepam prevented later mild dissociative episodes. By the end of treatment, suicidal ideation had resolved. The case suggests that dissociative reactions to esketamine are typically self-limiting and manageable, and that music intervention may help by modulating prefrontal-amygdala circuits and autonomic regulation.