Comparative Efficacy and Safety of Ketamine Versus Electroconvulsive Therapy in Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials.
Zhijian Ma, Fengle Wu, Wen Zheng
Psychiatric Quarterly February 18, 2025 DOI: 10.1007/s11126-025-10121-1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 643 |
| Population | Patients with major depressive disorder |
| Interventions | Ketamine Electroconvulsive therapy |
| Topics | Depression Ketamine Esketamine |
| Keywords | Electroconvulsive therapy Meta-analysis Depression treatment Ketamine therapy Mental health research Comparative medicine |
| Citations | 4 |
| Key findings | Ketamine is non-inferior to ECT for treating major depressive disorder and offers better memory function outcomes. |
Abstract
This meta-analysis aimed to compare the efficacy and safety of ketamine versus electroconvulsive therapy (ECT) in patients with major depressive disorder(MDD). A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases up to November 2024. The randomized controlled trials evaluating the efficacy and safety of ketamine and ECT in MDD patients were included. Pooled standardized mean differences (SMD) and risk ratios (RR) were calculated with 95% confidence intervals. The Cochrane's Risk of Bias Tool was employed to assess study quality. Six studies encompassing 643 patients were analyzed. No significant difference was observed in depression symptom severity scores between ketamine and ECT groups (SMD: -0.02, 95% CI: -0.53 to 0.48, P = 0.92). Response rates also showed no significant difference between the two interventions (RR: 1.08, 95% CI: 0.67 to 1.72, P = 0.76). Notably, ketamine demonstrated superior memory function improvement compared to ECT (SMD: 2.02, 95% CI: 1.64 to 2.48, P < 0.001). In terms of adverse events, ketamine was associated with significantly higher rates of dissociative symptoms, blurred vision, and dizziness(all P < 0.001), while demonstrating a lower incidence of muscle pain(P < 0.001). The meta-analysis revealed ketamine as a non-inferior therapeutic option for patients with major depressive disorder, with potential advantages in memory function. While promising, the limited number of included studies necessitates further large-scale randomized controlled trials using standardized assessment scales to validate these findings.
Comparable studies
Other systematic reviews and meta-analyses on ketamine for depression, most cited first.
Citations in the library
Cited by 2
- Interdisciplinary, Delphi-driven consensus guidelines on the use of intravenous ketamine infusions for depressive disorders from the American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3). Journal of Affective Disorders May 16, 2026
- Time matters for metas: a systematic review and meta-analysis of ect vs ketamine for depression incorporating time. Translational Psychiatry January 23, 2026
Cites 15
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Mechanisms of Ketamine Action as an Antidepressant Molecular Psychiatry March 13, 2018
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Better Biomarkers, Faster Drugs, Stronger Models: Progress Towards Precision Psychiatry. Missouri medicine 2023
- Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective Psychiatry and Clinical Neurosciences June 19, 2019
and 10 more in the library