The use of ketamine in electroconvulsive therapy.
K. Kucia, W. Merk
Psychiatria Polska 2015 DOI: 10.12740/pp/31748 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Ketamine |
| Topics | Esketamine Ketamine |
| Key findings | Argues that ketamine used during ECT has a good safety profile and minimal effect on seizure threshold, and that combining it with other anaesthetics may improve hemodynamic parameters. Evidence on whether ketamine accelerates ECT's antidepressant effect is contradictory, with studies pointing to only brief effects, and the authors conclude that small study populations mean further research is needed. |
Abstract
In recent years, data on the possibility of rapid clinical improvement after administration of ketamine in patients diagnosed with depression have been published more frequently. Ketamine, used as an anaesthetic during ECT procedures, despite earlier concerns, has both: a good safety profile and minimal effect on seizure threshold, which is used in cases of non-response to ECT. Postulated action of ketamine causes a rapid resolution of depressive symptoms raised hopes to accelerate therapeutic effect of ECT in patients with severe depression, but studies provide contradictory data pointing to brevity of the observed effect. Studies examining the use of ketamine combined with other anaesthetic drugs emphasized not only its antidepressant effect, but also improvement in hemodynamic parameters during ECT treatment. The aim of this work on one hand is to make psychiatrists aware that the role of anaesthesiologist at ECT is not limited to anaesthetise a patient and provide muscle relaxation, and, on the other hand, to make anaesthesiologists aware that drugs they use have a significant effect on seizure parameters and indirectly on the effectiveness of ECT. Due to small size of studied populations the issue of antidepressant efficacy of ketamine requires further exploration.
Comparable studies
Other narrative reviews on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms | 2018 | Review | |
| Mechanisms of Ketamine Action as an Antidepressant | 2018 | Review | |
| Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation Adults with treatment-resistant depression | 2021 | Review | |
| Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) | 2013 | Review | |
| A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders | 2017 | Review and consensus statement |
Citations in the library
Cited by 2
- 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
- Ketamine for catatonia: A novel treatment for an old clinical challenge? A systematic review of the evidence. Schizophrenia Research September 1, 2024
Cites 6
- A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Archives of General Psychiatry August 1, 2006
- mTOR-Dependent Synapse Formation Underlies the Rapid Antidepressant Effects of NMDA Antagonists Science August 19, 2010
- Effectiveness of ketamine in depressed patients resistant to ECT or rTMS therapy. Psychiatria Polska February 20, 2014
- Clinically favourable effects of ketamine as an anaesthetic for electroconvulsive therapy: a retrospective study. European Archives of Psychiatry and Clinical Neuroscience December 2011
- Rapid antidepressant effect of ketamine anesthesia during electroconvulsive therapy of treatment-resistant depression: comparing ketamine and propofol anesthesia. The Journal of ECT September 2010
and 1 more in the library