Efficacy and safety of esketamine versus propofol in electroconvulsive therapy for treatment-resistant depression: A randomized, double-blind, controlled, non-inferiority trial.
Journal of affective disorders January 1, 2025 Qing-Bin Zeng, De-Cheng Zou, Xing-Bing Huang et al. 12 citations
For people with treatment-resistant depression, electroconvulsive therapy (ECT) is a common option. Esketamine, a fast-acting antidepressant, had not been tested as an anesthetic for ECT. In a double-blind randomized trial, 40 patients received either esketamine or propofol anesthesia for eight ECT sessions. Esketamine-ECT was non-inferior to propofol-ECT for reducing depressive symptoms after eight sessions. Response rates were 80% for esketamine versus 70% for propofol, and remission rates were 65% versus 55%, but non-inferiority was not confirmed for these outcomes. Cognitive function was similar between groups. Results for anxiety, suicidal ideation, and adverse events were inconclusive. Larger replication studies are needed.