Abstract
Rationale
Midazolam is a benzodiazepine which produces a dense anterograde amnesia, while permitting relatively well-preserved short-term memory, semantic retrieval, and other higher cognitive functions. Given these preserved abilities, we were interested in whether or not participants given midazolam would be aware of this anterograde amnesia.
Method
In the present experiment, participants were given midazolam in one testing session and a saline placebo in another. Participants provided judgments-of-learning (JOLs) immediately following study of cue-target pairs. During the test phase of the experiment, confidence levels and feeling-of-knowing (FOK) judgments were collected.
Results
Although cued recall performance was substantially impaired in the midazolam condition, mean JOLs were unaffected, indicating participants had little insight into their impairment during the study phase. Participants were relatively accurate in confidence levels and FOK judgments in the midazolam condition.
Conclusion
When studying items under the influence of midazolam, participants are unaware that their memory will be impaired. Implications for clinical practice and pharmacological studies of amnesia are discussed.
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References
Bacon E, Danion J, Kauffmann-Muller F, Schelstraete M, Bruant A, Sellal F, Grange D (1998) Confidence level and feeling of knowing for episodic and semantic memory: and investigation of lorazepam effects on metamemory. Psychopharmacology 138:318–325
Dunlosky J, Nelson TO (1992) Similarity between the cue for judgments of learning (JOL) and the cue for test is not the primary determinant of JOL accuracy. J Mem Lang 36:34–49
Dunlosky J, Domoto PK, Wang ML, Ishikawa T, Roberson I, Nelson TO, Ramsay DS (1998) Inhalation of 30% nitrous oxide impairs people’s learning without impairing people’s judgments of what will be remembered. Exp Clin Psychopharmacol 6:77–86
Evers AS, Maze M (2004) Anesthetic pharmacology: physiologic principles and clinical practice. Churchill Livingstone, Philadelphia
Greenblatt DJ, Abernethy DR, Locniskar A, Harmatz JS, Limjuco RA, Shader RI (1984) Effect of age, gender and obesity on midazolam kinetics. Anesthesiology 61:27–35
Hart JT (1967) Memory and the memory-monitoring process. J Verb Learn Verb Behav 6:685–691
Hennesy M, Kirkby K, Montgomery I (1991) Comparison of the amnesic effects of midazolam and diazepam. Psychopharmacology 103:545–550
Hirshman E, Passannante A, Henzler A (1999) The effect of midazolam on implicit memory tests. Brain Cogn 41:351–364
Hirshman E, Passannante A, Arndt J (2001) Midazolam amnesia and conceptual processing in implicit memory. J Exp Psychol Gen 130:453–465
Jackson J, Louwerens J, Cnossen F, de Jong H (1993) Testing the effects of hypnotics on memory via the telephone: fact or fiction? Psychopharmacology 111:127–133
Knoester PD, Jonker DM, van der Hoeven RTM, Vermeij TAC, Edelbroek PM, Brekelmans GJ, de Haan GJ (2002) Pharmacokinetics and pharmacodynamics of midazolam administered as a concentrated intranasal spray. A study in healthy volunteers. Br J Clin Pharmacol 53:501–507
Koriat A (1997) Monitoring one’s own knowledge during study: a cue-utilization approach to judgments of learning. J Exp Psychol Gen 126:349–370
Koriat A, Goldsmith M (1996) Monitoring and control processes in the strategic regulation of memory accuracy. Psychol Rev 103:490–517
Lovelace EA (1984) Metamemory: monitoring future recallability during study. J Exp Psychol Learn Mem Cogn 10:756–766
Mandema JW, Tuk B, van Steveninck AL, Breimer DD, Cohen AF, Danhof M (1992) Pharmacokinetic-pharmacodynamic modeling of the central nervous system effects of midazolam and its main metabolite alpha-hydroxymidazolam in healthy volunteers. Clin Pharmacol Ther 51:715–728
Metcalfe J, Shimamura AP (1994) Metacognition: knowing about knowing. MIT, Cambridge, Mass.
Mewaldt SP, Hinrichs JV, Ghoneim MM (1983) Diazepam and memory: support for duplex model of memory. Mem Cognit 11:557–564
Mintzer MZ, Griffiths RR (2003) Lorazepam and scopolamine: a single-dose comparison of effects on human memory and attentional processes. Exp Clin Psychopharmacol 11:56–72
Nelson TO (1984) A comparison of measures of the accuracy of feeling-of-knowing predictions. Psychol Bull 995:109–133
Nelson TO, Narens L (1990) Metamemory: a theoretical framework and new findings. Psychol Learn Motiv 26:125–173
Nelson TO, McSpadden M, Fromme K, Marlatt GA (1986) Effects of alcohol intoxication on metamemory and on retrieval from long-term memory. J Exp Psychol Gen 115:247–254
Nelson TO, Graf A, Dunlosky J, Marlatt A, Walker D, Luce K (1998) Effect of acute alcohol intoxication on recall and on judgments of learning during the acquisition of new information. In: Mazzoni G, Nelson TO (eds) Metacognition and cognitive neuropsychology: monitoring and control processes. Erlbaum, Mahwah, pp 161–180
Polster M, McCarthy R, O’Sullivan G, Gray P, Park G (1993) Midazolam-induced amnesia: implications for the implicit/explicit memory distinction. Brain Cogn 22:244–265
Rivas-Vazquez RA (2003) Benzodiazepines in contemporary clinical practice. Prof Psychol Res Pr 34:324–328
Schwartz BL (1994) Sources of information in metamemory: judgments of learning and feelings of knowing. Psychon Bull Rev 1:357–375
Schwartz BL, Benjamin AS, Bjork RA (1997) The inferential and experiential bases of metamemory. Curr Dir Psychol Sci 6:132–137
Shimamura A, Squire L (1988) Long-term memory in amnesia: cued recall, recognition memory, and confidence ratings. J Exp Psychol Learn Mem Cogn 14:763–770
Stafford RS, Ausiollo JC, Misra B, Saglam D (2000) National patterns of depression treatment in primary care. Prim Care Companion J Clin Psychiatry 2:211–216
Stoelting RK (1991) Pharmacology and physiology in anesthetic practice. Lippincott, Philadelphia
Veselis R, Reinsel R, Feschenko V, Wronski M (1997) The comparative amnestic effects of midazolam, propofol, thiopental, and fentanyl at equisedatie concentrations. Anesthesiology 87:749–764
Weingartner HJ, Joyce, EM, Sirocco KY, Adams CM, Eckardt, MJ, George T, Lister RJ (1993) Specific memory and sedative effects of the benzodiazepine triazolam. J Psychopharmacol 7:305–315
Acknowledgements
The work presented here was supported by a grant from the National Science Foundation to Elliot Hirshman.
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Merritt, P., Hirshman, E., Hsu, J. et al. Metamemory without the memory: are people aware of midazolam-induced amnesia?. Psychopharmacology 177, 336–343 (2005). https://doi.org/10.1007/s00213-004-1958-8
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DOI: https://doi.org/10.1007/s00213-004-1958-8