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Evaluation of Early Ketamine Effects on Belief-Updating Biases in Patients With Treatment-Resistant Depression

H. Bottemanne, O. Morlaàs, A. Claret, T. Sharot, P. Fossati, Liane Schmidt

JAMA psychiatry September 28, 2022 DOI: 10.1001/jamapsychiatry.2022.2996 via Semantic Scholar

Summary

In patients with treatment-resistant depression, a single ketamine infusion shifted belief updating toward a more optimistic bias within 4 hours. This early cognitive change was characterized by stronger asymmetrical reinforcement learning and, after one week of treatment, mediated the clinical antidepressant effect. The findings offer new insights into how fast-acting antidepressants alter cognition, which could be harnessed to promote lasting clinical improvement and treatment responsiveness.

Study at a glance

Characteristics Case-control study Peer reviewed
Population Patients with treatment-resistant depression
Keywords Medicine Psychology
Citations 59
Key finding Belief updating became more optimistically biased as soon as 4 hours after a first ketamine infusion, and this effect mediated the clinical antidepressant response at 1 week.

Abstract

Key Points Question What are the effects of ketamine on belief updating in patients with treatment-resistant depression (TRD)? Findings This case-control study in patients with TRD showed that belief updating became more optimistically biased as soon as 4 hours after a first ketamine infusion. This early cognitive effect of ketamine was formalized by stronger asymmetrical reinforcement learning and mediated at 1 week of treatment the clinical antidepressant effect. Meaning These findings provide new perspectives for the understanding of the cognitive effects of fast-acting antidepressants that potentially can be leveraged to promote sustained clinical improvement and treatment responsiveness.

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