Comparative Effect of Intravenous Ketamine and Electroconvulsive Therapy in Major Depression: A Randomized Controlled Trial
G. Kheirabadi, M. Vafaie, Dorna Kheirabadi, Zahra Mirlouhi, Rasam Hajiannasab
Advanced Biomedical Research April 10, 2019 DOI: 10.4103/abr.abr_166_18 via Semantic Scholar
Summary
Intravenous ketamine and electroconvulsive therapy (ECT) produce similar improvements in depressive symptoms among adults with major depressive disorder. In a randomized trial with 32 patients, both treatments reduced depression severity on the Hamilton Depression Rating Scale, with no statistically significant difference between the groups. Cognitive function was slightly better in the ketamine group, though this difference was not statistically significant. Ketamine treatment did not cause memory deficits, unlike ECT which is often associated with cognitive side effects. The findings suggest ketamine may be a viable alternative to ECT for treating major depression.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 32 |
| Population | Adult patients with major depressive disorder who were candidates for ECT |
| Keywords | Medicine |
| Key finding | Intravenous ketamine and ECT produced comparable antidepressant effects, with ketamine showing a nonsignificant advantage in cognitive function. |
Abstract
Background: Achieving a rapid onset and durable methods of treatment for major depressive disorders is an issue pursuing in psychiatry. This study was designed to assess the therapeutic efficacy of intravenous (IV) ketamine injection in controlling depressive symptoms in comparison with electroconvulsive therapy (ECT) in major depressed disordered patients. Materials and Methods: Thirty-two patients over 18 years of age who were candidates for ECT were enrolled in the study. They were allocated into two groups using block design randomization. Sixteen patients received IV infusion of 0.5-mg/kg ketamine and 16 patients underwent a bitemporal ECT. To evaluate the changes in depression severity, researchers administered Hamilton Depression Rating Scale (HDRS) at baseline, before each treatment session, and four time points posttreatment (week 1 and months 1, 2, and 3). The Wechsler Memory Scale was used to evaluate the cognitive state of patients in week 1, month 1, and month 3 of the treatment. Results: The HDRS showed improvement in depressive symptoms in both the groups with no statistically significant difference. Cognitive state was more favorable (but not significant) in the ketamine group (P > 0.5). Conclusion: Treatment with IV ketamine in depressed people has the same antidepressant effects as ECT treatment without any memory deficiency.