Intermittent administration of low dose ketamine can shorten the course of electroconvulsive therapy for depression and reduce complications: A randomized controlled trial.
Jun Dong, S. Min, H. Qiu, Qibin Chen, Li Ren
Psychiatry Research November 1, 2019 DOI: 10.1016/j.psychres.2019.112573 via Semantic Scholar
Summary
For patients with major depressive disorder, adding a low dose of ketamine to electroconvulsive therapy (ECT) once a week improved remission rates and reduced psychiatric complications compared with giving ketamine before every ECT session. In a randomized trial of 134 patients, those receiving intermittent ketamine had a complication rate of 4.35%, far lower than the 20.93% rate in the repeated-ketamine group and similar to the 0% rate in the routine ECT group. Both ketamine regimens led to higher remission than ECT alone. Intermittent low-dose ketamine appears to boost ECT's effectiveness while minimizing side effects.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 134 |
| Population | Patients diagnosed with Major Depressive Disorder (MDD) |
| Keywords | Medicine |
| Citations | 26 |
| Key finding | Intermittent low-dose ketamine added to ECT improved remission rates and reduced psychiatric complications compared with repeated ketamine administration. |
Abstract
This study aimed to investigate the efficacy and safety of intermittent low-dose ketamine on improving the efficacy of ECT. Patients diagnosed with Major Depressive Disorder (MDD) (n = 134) were randomized into 3 groups: routine ECT group (group E, n = 45); repeated ketamine-assisted ECT group (group RK, n = 43), and intermittent ketamine-assisted ECT group (group IK, n = 46). Patients in group RK were given ketamine at the dose of 0.3 mg/kg for each ECT treatment, patients in group IK were given ketamine once a week during ECT course. The depressive symptoms were assessed using the Hamilton Depression Rating Scale (HAM-D) at baseline, the end of ECT course, after 1 and 3 months, followed by an analysis of the psychiatric complications. Results indicated that ketamine-assisted ECT achieved a higher remission rate (P < 0.05), and no difference was observed between repeated and intermittent ketamine administrations. The total incidence rate of psychiatric complications in group RK (20.93%) was higher than that in group E (0%) and group IK (4.35%). In conclusion, intermittent administration of low dose ketamine in ECT significantly improved the effects of ECT and decreased psychiatric complications compared with repeated ketamine addition.