Longitudinal dream-content shift and void-like dissociative phenomenology around outpatient ketamine infusions in chronic low back pain: a case report.
Journal of medical case reports July 13, 2026 Kei Torii, Ryo Nishitani
A 48-year-old Japanese man with severe chronic primary low back pain reported over 360 dreams during insight-oriented psychotherapy from 2009 to 2025. In 2014, he received five low-dose intravenous ketamine infusions (15 mg; 0.23 mg/kg) and described a void-like dissociative state during the first session. After coding a random subset of 50 dreams, obstruction decreased from pre- to post-ketamine periods (treating clinician: 6/9 vs 4/30; external psychiatrist: 6/9 vs 7/30), while a social-interaction/role-completion motif increased post-ketamine (2/9 pre; 10/30 and 11/30 post). Dream content shifted from recurrent obstruction toward imagery of movement, interpersonal engagement, and everyday role completion. These hypothesis-generating observations describe ketamine-associated phenomenology and longitudinal dream-content change without making efficacy claims.