Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial
Abstract Background Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Child and Adolescent Psychiatry and Mental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13034-023-00647-2 |
| _version_ | 1827635560562294784 |
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| author | Xiaofeng Lan Chengyu Wang Fan Zhang Haiyan Liu Weicheng Li Yanxiang Ye Zhibo Hu Siming Mai Yuping Ning Yanling Zhou |
| author_facet | Xiaofeng Lan Chengyu Wang Fan Zhang Haiyan Liu Weicheng Li Yanxiang Ye Zhibo Hu Siming Mai Yuping Ning Yanling Zhou |
| author_sort | Xiaofeng Lan |
| collection | DOAJ |
| description | Abstract Background Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder (MDD) and suicidal ideation. Method In this randomized-controlled trial, 51 participants aged 13–18 with MDD and suicidal ideation received three intravenous infusions of either esketamine (0.25 mg/kg) or midazolam (0.02 mg/kg). Four dimensions of the MATRICS Consensus Cognitive Battery (MCCB), including processing speed, working memory, verbal learning and visual learning, were assessed at Days 0, 6 and 12. Results In the linear mixed model, a significant time main effect (F = 12.803, P < 0.001), drug main effect (F = 6.607, P = 0.013), and interaction effect (F = 3.315, P = 0.041) was found in processing speed. Other dimensions including working memory and verbal learning showed significant time main effect (all P < 0.05), but no significant drug or interaction effect (all P > 0.05). Esketamine group showed improvement in processing speed from baseline to Days 6 and 12, and working memory from baseline to Day 12 (all P < 0.05). The generalized estimation equation showed no significant association between baseline cognition and antidepressant or antisuicidal effect (both P > 0.05). Conclusions The present study suggested that three-dose subanesthetic esketamine infusions did not harm cognition among adolescents with MDD and suicidal ideation. Instead, esketamine may be associated with improvement in processing speed. Trial registration: This trial was registered in the Chinese Clinical Trials Registry ( http://www.chictr.org.cn , ChiCTR2000041232). |
| first_indexed | 2024-03-09T15:29:22Z |
| format | Article |
| id | doaj.art-7c985ab8481e45a4a2e796f3554a15eb |
| institution | Directory Open Access Journal |
| issn | 1753-2000 |
| language | English |
| last_indexed | 2024-03-09T15:29:22Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Child and Adolescent Psychiatry and Mental Health |
| spelling | doaj.art-7c985ab8481e45a4a2e796f3554a15eb2023-11-26T12:22:02ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002023-09-0117111010.1186/s13034-023-00647-2Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trialXiaofeng Lan0Chengyu Wang1Fan Zhang2Haiyan Liu3Weicheng Li4Yanxiang Ye5Zhibo Hu6Siming Mai7Yuping Ning8Yanling Zhou9Department of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityDepartment of Child and Adolescent Psychiatry, Affiliated Brain Hospital of Guangzhou Medical UniversityAbstract Background Ketamine and its enantiomer have rapid and robust effects on depressive symptom and suicidal ideation. Little is known about their cognitive effects in adolescents. We aimed to evaluate the short-term effect of esketamine on cognition in adolescents with major depressive disorder (MDD) and suicidal ideation. Method In this randomized-controlled trial, 51 participants aged 13–18 with MDD and suicidal ideation received three intravenous infusions of either esketamine (0.25 mg/kg) or midazolam (0.02 mg/kg). Four dimensions of the MATRICS Consensus Cognitive Battery (MCCB), including processing speed, working memory, verbal learning and visual learning, were assessed at Days 0, 6 and 12. Results In the linear mixed model, a significant time main effect (F = 12.803, P < 0.001), drug main effect (F = 6.607, P = 0.013), and interaction effect (F = 3.315, P = 0.041) was found in processing speed. Other dimensions including working memory and verbal learning showed significant time main effect (all P < 0.05), but no significant drug or interaction effect (all P > 0.05). Esketamine group showed improvement in processing speed from baseline to Days 6 and 12, and working memory from baseline to Day 12 (all P < 0.05). The generalized estimation equation showed no significant association between baseline cognition and antidepressant or antisuicidal effect (both P > 0.05). Conclusions The present study suggested that three-dose subanesthetic esketamine infusions did not harm cognition among adolescents with MDD and suicidal ideation. Instead, esketamine may be associated with improvement in processing speed. Trial registration: This trial was registered in the Chinese Clinical Trials Registry ( http://www.chictr.org.cn , ChiCTR2000041232).https://doi.org/10.1186/s13034-023-00647-2EsketamineSuicidal ideationAdolescentDepressionCognition |
| spellingShingle | Xiaofeng Lan Chengyu Wang Fan Zhang Haiyan Liu Weicheng Li Yanxiang Ye Zhibo Hu Siming Mai Yuping Ning Yanling Zhou Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial Child and Adolescent Psychiatry and Mental Health Esketamine Suicidal ideation Adolescent Depression Cognition |
| title | Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial |
| title_full | Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial |
| title_fullStr | Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial |
| title_full_unstemmed | Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial |
| title_short | Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial |
| title_sort | short term cognitive effects of repeated dose esketamine in adolescents with major depressive disorder and suicidal ideation a randomized controlled trial |
| topic | Esketamine Suicidal ideation Adolescent Depression Cognition |
| url | https://doi.org/10.1186/s13034-023-00647-2 |
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