AUTHOR=Hauser Johannes , Sarlon Jan , Liwinski Timur , Brühl Annette B. , Lang Undine E. 

TITLE=Listening to music during intranasal (es)ketamine therapy in patients with treatment-resistant depression correlates with better tolerability and reduced anxiety

JOURNAL=Frontiers in Psychiatry

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1327598

DOI=10.3389/fpsyt.2024.1327598

ISSN=1664-0640

ABSTRACT=<sec id="sec1"><title>Background</title><p>Although the effectiveness of (es)ketamine for therapy-resistant depression (TRD) has been established, potential treatment-limiting factors include side effects like dissociation, anxiety, or elevated blood pressure. Music can reduce stress and negative emotions as anxiety. This study aimed to investigate the impact of listening to music during intranasal (es)ketamine administration on both tolerability and efficacy.</p></sec><sec id="sec2"><title>Methods</title><p>Records of 494 sessions (of 37 patients) with intranasal (es)ketamine administration, each containing data of blood pressure measurements, DSS-IV (dissociation symptoms scale-IV), anxiety and euphoria analogue scale, MADRS (Montgomery–Åsberg Depression Rating Scale) and BDI (Beck’s Depression Inventory) were evaluated.</p></sec><sec id="sec3"><title>Results</title><p>The between-group analysis, comparing participants who listened to music with those who did not, revealed significant differences in the administered dose (<italic>p</italic>-value: 0.003, mean: 131.5 mg with music vs. 116.7 mg without music), scores on the DSS Item 1 (<italic>p</italic>-value: 0.005, mean: 3 points vs. 2.4 points), levels of anxiety (<italic>p</italic>-value: &lt;0.001, mean: 0.4 points vs. 1.4 points), and measurements of maximal systolic blood pressure after administration (<italic>p</italic>-value: 0.017, mean: 137.9 mmHg vs. 140.3 mmHg). Listening to music had no impact on the MARDS-change score between the sessions.</p></sec><sec id="sec4"><title>Limitations</title><p>Key limitations include a non-randomized naturalistic design and the non-standardized selection of music, which was based on individual patient preferences.</p></sec><sec id="sec5"><title>Conclusion</title><p>Listening to music during intranasal (es)ketamine therapy appears to be linked to reduced anxiety and lower blood pressure, stable or increased dissociation levels, and improved tolerance for higher doses. These findings could potentially contribute to the optimization of (es)ketamine therapy, both in terms of treatment efficacy and managing side effects.</p></sec>