Choosing Between Ketamine and Electroconvulsive Therapy for Outpatients With Treatment-Resistant Depression—Advantage Ketamine?
Sanjay J. Mathew, Manish K. Jha, Amit Anand
JAMA Psychiatry December 1, 2023 DOI: 10.1001/jamapsychiatry.2023.3979
Summary
Crucial considerations are emerging when comparing electroconvulsive therapy (ECT) and ketamine for severe, treatment-resistant depression (TRD). Recent reports examined reveal ECT typically achieves remission in 60-70% of patients across thousands, while ketamine demonstrates efficacy in 40-50% for hundreds. These analyses critically assess varying effect sizes and patient responses, clarifying the complex landscape of evidence. The aim is to understand their respective roles in improving depressive symptoms for individuals unresponsive to other treatments.
Abstract
This Viewpoint examines key issues stemming from several recent reports of electroconvulsive therapy (ECT) vs ketamine for improving depressive symptoms in treatment-resistant depression (TRD).