Electroconvulsive therapy versus intravenous ketamine as a novel treatment in depressive disorders: Review of the literature
Marcin Głód, Dominika Kabała, Adam Jaskulski, Agata Zapałowska, Michał Bielecki, Milena Szczepańska, Tymon Zatorski
Medical Science August 30, 2024 DOI: 10.54905/disssi.v28i150.e105ms3425 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | Patients with depressive disorders, including treatment-resistant depression, enrolled in randomized clinical trials and clinical trials |
| Interventions | Intravenous ketamine Electroconvulsive therapy (ECT) |
| Topics | Depression Esketamine Ketamine |
| Key findings | Across five trials comparing intravenous ketamine with ECT, three found ketamine non-inferior, sometimes with faster onset and greater symptom reduction, while two found it inferior. The authors conclude that ketamine still shows strong antidepressant properties and may be effective, particularly when ECT is contraindicated or patients are reluctant to undergo it, but larger trials are needed. |
Abstract
Aim: In this review, we assessed the state of available knowledge regarding the antidepressant action of intravenous ketamine versus electroconvulsive therapy (ECT) in randomized clinical trials and clinical trials.
Methods: To search for the eligible articles, the PubMed database was used. Five studies were selected using the inclusion criteria, and their findings are presented in our review.
Results: Five articles were selected. Three of them showed that ketamine is non-inferior to ECT, and in some patients, it had a faster onset and reduced depressive symptoms more significantly than ECT. Two of the selected articles concluded that ketamine is inferior to ECT. However, it is still a potent treatment that can induce response or remission faster than antidepressant drugs, even in patients suffering from treatment-resistant depression. Discussion and
Conclusions: As antidepressant properties of ketamine remain a relatively new discovery, further research needs to be conducted regarding its efficacy in the treatment of depressive disorders in relation to ECT, especially trials enrolling more participants. It is vital to note that even if two trials showed the inferiority of ketamine to ECT, all of them concluded that ketamine exhibits strong antidepressant properties and may prove to be an effective treatment, especially when ECT may be contraindicated, or patients are reluctant to it.
Comparable studies
Other systematic reviews and meta-analyses on ketamine for depression, most cited first.