Combining Intranasal Esketamine and Electroconvulsive Therapy in Severe Treatment‑Resistant Depression
Journal of Ect – January 29, 2026
Source: OpenAlex
Summary
Combining electroconvulsive therapy (ECT) with nasal ketamine (ESK) demonstrated promising results in treating treatment-resistant depression. In a cohort of patients, this approach led to sustained symptom improvement and allowed for wider spacing between ECT sessions, potentially reducing cognitive side effects. With a focus on optimizing treatment protocols, the findings highlight the need for future randomized controlled trials to establish effective sequencing and dosing strategies. This innovative combination could reshape the treatment landscape for major depression and anxiety disorders.
Abstract
In this naturalistic series, combined ECT+ESK was feasible and associated with sustained symptom improvement, wider ECT spacing, and potentially lower cognitive burden. Findings are hypothesis-generating, support prospective controlled trials to define sequencing, dosing, and safety.