Case Report: A possible association between significant dissociations after esketamine treatment and histrionic personality disorder
Frontiers in Psychiatry December 17, 2025 Veronika Savica, Liene Sīle, Māris Taube 1 citation
Dissociation—a disruption in the normal integration of psychological functions—is a common adverse effect of esketamine nasal sprays. Individuals with high trait dissociation face greater risk of severe induced dissociation. However, intense dissociation may also predict better therapeutic response. This case report describes a patient with histrionic personality disorder (HPD) who experienced an unusually intense and persistent dissociative reaction during esketamine therapy. The case suggests that certain HPD personality traits may heighten vulnerability to esketamine-induced dissociation, underscoring the need to identify patient-level factors that amplify dissociative responses for improved risk stratification and clinical care.