The effect of ketamine on cognition, anxiety, and social functioning in adults with psychiatric disorders: A systematic review and meta-analysis
This meta-analysis (n=1,298) explored the effects ketamine has on cognition, anxiety, quality of life, and social functioning in adults with psychiatric disorders. Ketamine was found to have positive effects on depression, anxiety and social functioning but not with respect to cognition and quality of life.
Authors
- Marchi, M.
- Magarini, F. M.
- Galli, G.
Published
Abstract
Background
It has been shown that ketamine can improve suicidality and depression. Evidence for other dimensions of psychopathology is lacking. We undertook a systematic review to investigate the effect of ketamine on cognition, anxiety, quality of life, and social functioning in adults with psychiatric disorders.
Methods
PubMed (Medline), Scopus, PsycINFO, and EMBASE were searched up to April 2022. Randomized controlled trials (RCTs) on ketamine [or its S (+) enantiomer] reporting data on cognition, anxiety, quality of life, social functioning in adults with psychiatric disorders were included. Standardized mean difference (SMD) was used for summarizing continuous outcomes.
Results
Twenty-two reports were included in the final selection, of which 20, corresponding to 1,298 participants, were included in the quantitative synthesis. Affective disorders were the predominant diagnostic category. Median follow-up time was 21 days. The evidence was rated moderate to very low. In most trials, ketamine was administered intravenously or as adjuvant to electro-convulsant therapy (ECT). Only 2 trials of intranasal esketamine were identified. The effect of ketamine on depression was confirmed (SMD: −0.61 [95% CI: −1.06; −0.16]). Furthermore, by pooling results of 6 RCTs, ketamine may be effective in reducing anxiety symptoms (SMD: −0.42 [95% CI: −0.84; 0.003]), particularly when administered not within ECT (5 trials; SMD: −0.58 [95% CI: −1.07; −0.09]). However, there was moderate heterogeneity of results. Patients treated with ketamine also had an improvement in social functioning (SMD: −0.31 [95% CI: −0.52; −0.10]), although the estimate was based only on 2 studies. No difference to comparators was found with respect to cognition and quality of life.
Conclusion
Alongside the antidepressant effect, ketamine may also improve anxiety and social functioning in adults with affective disorders.
Research Summary of 'The effect of ketamine on cognition, anxiety, and social functioning in adults with psychiatric disorders: A systematic review and meta-analysis'
βBlossom's Take
Ketamine may reduce anxiety and improve social functioning, but not cognition or quality of life
SourcedWhat did the meta-analysis find across non-depressive outcomes in adults with psychiatric disorders?
- 1,298
- participants in quantitative synthesis
- 6 RCTs
- anxiety pooling base
- 2 studies
- social functioning pooling base
- No difference
- cognition outcome
Key synthesis results
Systematic review and meta-analysis of randomised controlled trials in adults with psychiatric disorders. The figures here are the paper's own pooled results, they do not establish causality for long term outcomes, and the social functioning estimate is based on only 2 studies while anxiety showed moderate heterogeneity.
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Study Details
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