A Comparative Study on the Effectiveness of Electroconvulsive Therapy and Ketamine in Persons Suffering from Treatment-resistant Depressive Disorder
V. Ramasubramanian, S. Mathumathi, G. Thirumalaisamy, Sugaparaneetharan Ayyanar, Gopi Rajendhiran, M. Kannan
Indian Journal of Psychiatric Nursing July 1, 2024 DOI: 10.4103/iopn.iopn_93_23 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective, parallel randomized controlled, open label, noninferiority/superiority trial Open-label Peer reviewed |
|---|---|
| Sample size | 96 |
| Population | People with treatment-resistant depression |
| Interventions | Ketamine Electroconvulsive therapy (ECT) |
| Dose | six doses of ketamine; 6 ECT treatments |
| Measures | Hamilton depression ratings scale (HAM-D) |
| Topics | Depression Esketamine Ketamine |
| Key findings | Ketamine produced an antidepressant effect comparable to ECT in people with treatment-resistant depression, and the authors report that it reduced depressive symptoms more rapidly than ECT. They conclude that ketamine can be considered an effective alternative to ECT in this population. |
Abstract
ABSTRACT Depression is a common illness that affects about 3.8% of the population worldwide. Patients with major depression respond to antidepressant treatment, but 10%–20% of them do not improve or show a partial response. It is coupled with functional impairment, poor quality of life, suicide ideation and attempts, self-injurious behavior, and a high relapse rate. Treatment-resistant depression (TRD) is a challenge to clinicians because of its increased loss of functionality and the increased rate of suicide among people diagnosed with the illness. Studies are evolving to combine various treatment options to reduce morbidity and mortality in people suffering from the illness. This study aims at comparing the efficacy of electroconvulsive therapy (ECT) and ketamine transfusion in treating TRD. It hopes to prove that ketamine provides rapid relief for people suffering from TRD. A prospective, parallel randomized controlled, open label, noninferiority/superiority trial to compare the efficacy of ECT and ketamine was done. Ninety-six persons suffering from TRD were selected for the study through proportionate stratified random sampling and 46 persons received 6 ECT treatment and 50 persons received six doses of ketamine. Treatment response was measured using Hamilton depression ratings scale (HAM-D) using baseline, mid assessment, and postassessment scores. The scores were used to determine the effectiveness of ECT and ketamine in the treatment of TRD. Ketamine was proven to have the same antidepressant effect in participants as that of ECT. Ketamine was observed to have rapid reduction in depressive symptoms when compared to ECT. This study highlights that ketamine can be considered as an effective alternative to ECT in those with TRD.
Comparable studies
Other randomized controlled trials on ketamine for depression, most cited first.