Halls, Georgia;
(2020)
The Cognitive Effects of Sub-Anesthetic Ketamine and Lidocaine in individuals with a diagnosis of Chronic Pain.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Background and Aim: Since ketamine was first trialed as an anti-depressant in 2000, it has been growing in popularity due to its fast-onset anti-depressant effects. The cognitive effects of ketamine when self-administered recreationally or administered acutely to healthy participants have been examined in many studies (Morgan & Curran, 2006). However, it is unclear how ketamine may impact cognitively on people with treatment-resistant depression, as mood and cognitive functioning are closely linked. The aim of this paper is to review current understanding of the cognitive effects of ketamine when used to treat individuals with treatment-resistant depression. Method: A systematic review of PsycINFO, Embase and OVID MEDLINE was conducted to find studies that utilised cognitive assessments during ketamine infusions in patients with treatment-resistant depression. Seventeen articles were identified and met the inclusion criteria for the review. There were three types of articles included that explored the cognitive effects of ketamine. Firstly those that used sub-anaesthetic ketamine infusions, secondly those used sub-anaesthetic ketamine infusions plus an anaesthetic agent, and thirdly those that used anaesthetic ketamine infusions. Included studies were quality assessed using the Cochrane Risk of Bias 2 and Risk of Bias in Non-Randomised Studies – of Interventions. Results: Of the 17 articles included, 10 found that when changes in depression symptomology were controlled for, both acute and repeated ketamine infusions were not significantly associated with cognitive performance. Three of the papers found that baseline cognitive functioning could predict individual’s improvements in mood following ketamine administration. Methodological variations meant a wide range of cognitive domains were explored, using various ketamine dosages and assessment intervals. There was considerable variability in the quality of the research. Conclusions: Methodological heterogeneity rendered findings inconclusive as to whether ketamine affects cognitive functioning within a treatment-resistant depression population. The relationship between ketamine’s impact on mood and subsequent cognitive changes are important to assess. Further high quality research needs to be done to fully document the cognitive side-effects of ketamine infusions so that patients and their doctors can make fully informed decisions.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | The Cognitive Effects of Sub-Anesthetic Ketamine and Lidocaine in individuals with a diagnosis of Chronic Pain |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10110220 |
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