Journal
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
Volume 120, Issue -, Pages 78-85Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.neubiorev.2020.11.020
Keywords
Neurocognition; Major depression; Racemic ketamine; Esketamine; Treatment-resistant depression
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Research suggests that intravenous ketamine may have positive effects on cognition in TRD patients, including improvements in working memory and visual learning memory, although symptoms in anxious TRD participants may show more significant improvement.
Replicated evidence has documented cognitive deficits in populations with treatment-resistant depression (TRD). Approximately 40 % of patients with MDD present with impairment of one or more cognitive domains. As such, there is an unmet need to discover treatments that have pro-cognitive effects in TRD patients. Ketamine has demonstrated efficacy as a rapid-onset intervention for the treatment of depression. The objective of the current review was to assess the effects of ketamine on cognition in TRD patients. We systematically searched PubMed, Google Scholar and PsycINFO between database inception to March 24th, 2020. We identified five studies that evaluated cognition in TRD populations following ketamine treatment. All studies included a 0.5 mg/kg subanesthetic intravenous (IV) administration of ketamine. One study found significant improvements in complex (p = .008) and simple (p = .027) working memory and one study found improvements in visual learning memory following IV ketamine infusions (p = .014). Improvements in speed of processing and verbal learning memory were observed in anxious TRD participants only. Importantly, a sub anesthetic dose of IV ketamine does not worsen cognitive function.
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