AUTHOR=Marchi Mattia , Magarini Federica Maria , Galli Giacomo , Mordenti Federico , Travascio Antonio , Uberti Daniele , De Micheli Edoardo , Pingani Luca , Ferrari Silvia , Galeazzi Gian Maria 

TITLE=The effect of ketamine on cognition, anxiety, and social functioning in adults with psychiatric disorders: A systematic review and meta-analysis

JOURNAL=Frontiers in Neuroscience

VOLUME=Volume 16 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.1011103

DOI=10.3389/fnins.2022.1011103

ISSN=1662-453X

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 1298 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.