A New Perspective on the Anti-Suicide Effects With Ketamine Treatment
Yena Lee, Kahlood Syeda, Nadia A. Maruschak, Danielle S. Cha, Rodrigo B. Mansur, Ida Kim Wium‐Andersen, Hanna O. Woldeyohannes, Joshua D. Rosenblat, Roger S. McIntyre
Journal of Clinical Psychopharmacology December 12, 2015 DOI: 10.1097/jcp.0000000000000441 via OpenAlex
Summary
A single, low-dose administration of ketamine can rapidly reduce depressive symptoms in adults with treatment-resistant mood disorders and may also have antisuicide effects. The antidepressant effects may be partly mediated by targeting neural circuits involved in executive function and cognitive emotional processing. Pretreatment cognitive function predicts treatment outcomes, suggesting that beneficial effects on cognition could be a proximate mechanism for symptom relief, even though ketamine is known to impair cognitive function. Recent reviews and meta-analyses conclude that ketamine has possible clinical benefits in refractory mood disorders, and its salutary effects, particularly on suicidality, may involve procognitive mechanisms.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Population | Adults with treatment-resistant mood disorders |
| Topics | Anxiety Ketamine |
| Keywords | Cognition Mechanism biology Antidepressant Mood disorders |
| Citations | 75 |
| Key finding | Ketamine's antidepressant and antisuicide effects may be partly mediated by targeting neural circuits involved in cognitive processing, and pretreatment cognitive function predicts treatment outcomes. |
Abstract
Available evidence indicates that a single, low-dose administration of ketamine is a robust, rapid-onset intervention capable of mitigating depressive symptoms in adults with treatment-resistant mood disorders. Additional evidence also suggests that ketamine may offer antisuicide effects. Herein, we propose that the antidepressant effects reported with ketamine administration are mediated, in part, by targeting neural circuits that subserve cognitive processing relevant to executive function and cognitive emotional processing. Empirical support for the conceptual framework of the cognitive domain as a critical target of ketamine's action is the additional observation that pretreatment cognitive function predicts treatment outcomes with ketamine administration. The proposal that beneficial effects on cognitive function may be, in some individuals, the proximate mechanism mitigating symptom relief in mood disorders exists alongside the well-established deleterious effect of ketamine on cognitive function. During the past 5 years, there have been several reviews and meta-analyses concluding that ketamine has possible clinical benefits in refractory mood disorders. We introduce the conceptual framework that ketamine's salutary effects, notably in suicidality, may in part be via procognitive mechanisms.