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Neurocognitive performance and repeated-dose intravenous ketamine in major depressive disorder.

Published on Mar 1, 2019in Journal of Affective Disorders4.084
· DOI :10.1016/J.JAD.2018.12.005
Wei Zheng128
Estimated H-index: 128
(Guangzhou Medical University),
Yanling Zhou8
Estimated H-index: 8
(Guangzhou Medical University)
+ 6 AuthorsYuping Ning15
Estimated H-index: 15
(Guangzhou Medical University)
Abstract
Abstract Objective Ketamine has demonstrated a rapid antidepressant and antisuicidal effect in patients with major depressive disorder (MDD), but the neurocognitive effects of ketamine are relatively unknown. This study aims to examine the neurocognitive effects of six ketamine infusions and the association of baseline neurocognitive function and the change in severity of depressive symptoms after the last infusions. Methods Sixty-four patients with MDD completed six intravenous infusions of ketamine (0.5 mg/kg over 40 min) administered over a 12-day period (Monday–Wednesday–Friday), and were followed by a 2-week observational period. Four domains of neurocognitive function (including speed of processing, working memory, visual learning and verbal learning) were assessed using the MATRICS Consensus Cognitive Battery (MCCB) at 0, 13 and 26 days. Results In linear mixed model, significant improvements were found in terms of speed of processing (F=20.7, p Conclusion Our findings suggest that six ketamine infusions were associated with the improvement of speed of processing and verbal learning, which were partly accounted for by improvement in the severity of depression symptoms over time.
  • References (53)
  • Citations (9)
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References53
Newest
#1Sonia VidalH-Index: 5
#2Marianne Gex-FabryH-Index: 30
Last. Markus KoselH-Index: 20
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BACKGROUND: Ketamine has been documented for its rapid antidepressant effects. However, optimal dose and delivery route have not yet been thoroughly investigated. The objectives of this study were to document the safety and test the antidepressant and antisuicidal effects of a single rapid 1-minute injection of ketamine 0.5 mg/kg in treatment-resistant depression (TRD). METHODS: Ten patients with TRD were included in an open, noncontrolled 4-week study and received a rapid intravenous dose of ke...
11 CitationsSource
#1Mark Sinyor (U of T: University of Toronto)H-Index: 18
#2Marissa Williams (Athabasca University)H-Index: 2
Last. Ayal Schaffer (U of T: University of Toronto)H-Index: 30
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Abstract Background Ketamine is known to rapidly reduce depressive symptoms and suicidal ideation (SI) in patients with major depressive disorder (MDD), but evidence is limited for its acceptability and effectiveness in “real-world” settings. This case series examines serial ketamine infusions in reducing SI and depression scores in adults with MDD admitted to a tertiary care hospital. Methods Five inpatients with MDD and SI admitted to hospital in Toronto, Canada received six infusions of 0.5 m...
8 CitationsSource
#1Wei Zheng (Guangzhou Medical University)H-Index: 128
#2Yanling Zhou (Guangzhou Medical University)H-Index: 4
Last. Yuping Ning (Guangzhou Medical University)H-Index: 15
view all 9 authors...
Abstract Objective Single-dose intravenous (IV) injection of ketamine has shown rapid but transient antidepressant effects. The strategy of repeated-dose ketamine infusions to maintain antidepressant effects has received little systematic study. This study was conducted to examine the efficacy and tolerability of six ketamine infusions in Chinese patients with unipolar and bipolar depression. Methods Ninety seven patients with unipolar (n = 77) and bipolar (n = 20) depression received repeated k...
25 CitationsSource
#1Yanling Zhou (Guangzhou Medical University)H-Index: 4
#2Wei Zheng (Guangzhou Medical University)H-Index: 128
Last. Yuping Ning (Guangzhou Medical University)H-Index: 15
view all 9 authors...
Background:Ketamine has proven to have rapid, robust antidepressant effects on treatment-resistant depression. However, whether repeated ketamine infusions would cause short-and long-term neurocogn...
9 CitationsSource
#1Xiaoyin Ke (Guangzhou Medical University)H-Index: 1
#2Yi Ding (Guangzhou Medical University)H-Index: 5
Last. Ni Fan (Guangzhou Medical University)H-Index: 8
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Abstract The aim of this study was to examine the cognitive function in chronic ketamine users. Factors correlated to cognition impairments were analyzed. Sixty-three chronic ketamine users and 65 healthy subjects were recruited. Cognitive function was assessed by using immediate/delayed visual reproduction (IVR/DVR) tasks, immediate/delayed logical memory (ILM/DLM) tasks, Stroop test, Wisconsin card sorting test (WCST), and continuous performance test (CPT). Psychopathological symptoms were ass...
7 CitationsSource
#1Panos Zanos (UMB: University of Maryland, Baltimore)H-Index: 19
#2Todd D. Gould (UMB: University of Maryland, Baltimore)H-Index: 46
Clinical studies have demonstrated that a single sub-anesthetic dose of the dissociative anesthetic ketamine induces rapid and sustained antidepressant actions. Although this finding has been met with enthusiasm, ketamine’s widespread use is limited by its abuse potential and dissociative properties. Recent preclinical research has focused on unraveling the molecular mechanisms underlying the antidepressant actions of ketamine in an effort to develop novel pharmacotherapies, which will mimic ket...
125 CitationsSource
#1Michael F. Grunebaum (CUMC: Columbia University Medical Center)H-Index: 35
#2Hanga Galfalvy (CUMC: Columbia University Medical Center)H-Index: 34
Last. J. John MannH-Index: 141
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Objective:Pharmacotherapy to rapidly relieve suicidal ideation in depression may reduce suicide risk. Rapid reduction in suicidal thoughts after ketamine treatment has mostly been studied in patients with low levels of suicidal ideation. The authors tested the acute effect of adjunctive subanesthetic intravenous ketamine on clinically significant suicidal ideation in patients with major depressive disorder.Method:In a randomized clinical trial, adults (N=80) with current major depressive disorde...
76 CitationsSource
#1Samuel T. Wilkinson (Yale University)H-Index: 13
#2Elizabeth D. Ballard (NIH: National Institutes of Health)H-Index: 23
Last. Gerard SanacoraH-Index: 56
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Objective:Suicide is a public health crisis with limited treatment options. The authors conducted a systematic review and individual participant data meta-analysis examining the effects of a single dose of ketamine on suicidal ideation.Method:Individual participant data were obtained from 10 of 11 identified comparison intervention studies that used either saline or midazolam as a control treatment. The analysis included only participants who had suicidal ideation at baseline (N=167). A one-stag...
121 CitationsSource
#1Jennifer L. Vande Voort (NIH: National Institutes of Health)H-Index: 16
#2Elizabeth D. Ballard (NIH: National Institutes of Health)H-Index: 23
Last. Carlos A. Zarate (NIH: National Institutes of Health)H-Index: 78
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OBJECTIVE: Insomnia and disrupted sleep are associated with increased risk of suicide. The N-methyl-d-aspartate antagonist ketamine has been associated with reduced suicidal thoughts, but the mechanism of action is unknown. This study sought to evaluate differences in nocturnal wakefulness in depressed individuals who did and did not have an antisuicidal response to ketamine. METHODS: Thirty-four participants with baseline suicidal ideation diagnosed with either DSM-IV major depressive disorder ...
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#1Joseph Kambeitz (LMU: Ludwig Maximilian University of Munich)H-Index: 21
#2Carlos Cabral (LMU: Ludwig Maximilian University of Munich)H-Index: 7
Last. Nikolaos Koutsouleris (LMU: Ludwig Maximilian University of Munich)H-Index: 39
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Abstract Background Multiple studies have examined functional and structural brain alteration in patients diagnosed with major depressive disorder (MDD). The introduction of multivariate statistical methods allows investigators to utilize data concerning these brain alterations to generate diagnostic models that accurately differentiate patients with MDD from healthy control subjects (HCs). However, there is substantial heterogeneity in the reported results, the methodological approaches, and th...
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Cited By9
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Abstract Background Suicidal ideation (SI) is common in patients with major depressive disorder (MDD) and often related to cognitive deficits. Limited longitudinal study has shown that cognitive improvement is associated with reduced SI. However, the comparatively study in Chinese depressed patients is still absent. The objective of this study was to explore the specific cognitive deficits in Chinese MDD with SI and investigate the relationship between changes in cognition and change in SI acros...
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#1Roberto Farina de Almeida (UFOP: Universidade Federal de Ouro Preto)H-Index: 10
#2Camila Barbosa Pocharski (UFRGS: Universidade Federal do Rio Grande do Sul)
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The treatment of major depressive disorder (MDD) is still a challenge. In the search for novel antidepressants, glutamatergic neuromodulators have been investigated as possible fast-acting antidepressants. Innovative studies suggest that the purine cycle and/or the purinergic signaling can be dysregulated in MDD, and the endogenous nucleoside guanosine has gained attention due to its extracellular effects. This study aimed to verify if guanosine produces fast-onset effects in the well-validated,...
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#1Dmitriy Matveychuk (U of A: University of Alberta)H-Index: 6
#2Rejish K Thomas (U of A: University of Alberta)H-Index: 5
Last. Serdar M. Dursun (U of A: University of Alberta)H-Index: 22
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Ketamine, a drug introduced in the 1960s as an anesthetic agent and still used for that purpose, has garnered marked interest over the past two decades as an emerging treatment for major depressive...
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The monocarboxylate transporters MCT1, MCT2, and MCT4 are essential components of the astrocyte-neuron lactate shuttle, which is a fundamental element of brain energetics. Decreased expression of monocarboxylate transporters can induce cognitive dysfunction of the brain. In present study, we established a mouse model of long-term ketamine administration by subjecting mice to a 6-month course of a daily intraperitoneal injection of ketamine. These mice demonstrated learning and memory deficits an...
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#1Millie Rincón-Cortés (University of Pittsburgh)H-Index: 9
#2Anthony A. Grace (University of Pittsburgh)H-Index: 95
Abstract Depression, the most prevalent psychiatric disorder, is characterized by increased negative affect (i.e. depressed mood) and reduced positive affect (i.e. anhedonia). Stress is a risk factor for depression in humans, and animal models of chronic stress are typically used to study neurobehavioral alterations relevant to depression. Common behavioral outcomes in rodent models of chronic stress include anhedonia, social dysfunction and behavioral despair. For example, chronically stressed ...
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#1Yanni Zhan (Guangzhou Medical University)H-Index: 7
#1Yanni Zhan (Southern Medical University)
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Abstract Background Suicide is a tremendous public health crisis and is demanded urgent intervention. Previous studies found that ketamine intervention could rapidly reduce suicidal ideation in depression. However, the comparatively study in Chinese population remains absence. The current study aims to assess the anti-suicidal efficacy of repeated ketamine infusions for Chinese depressed suicidal patients, especially distinguish between low suicidal ideation (SI) group and high SI group. Methods...
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