Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China. Electronic address: xyutly@gmail.com.
2 papers in the library · 13 citations · publishing 2025
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.
China's National Health Commission prioritizes early diagnosis and standardized treatment of major depressive disorder (MDD). Rapid treatment centers across the country use electroconvulsive therapy (ECT), intravenous ketamine/esketamine, esketamine nasal spray, magnetic seizure therapy (MST), and Stanford Neuromodulation Therapy (SNT). This policy and practice review examines the strengths and shortcomings of these techniques in China, noting their potential to accelerate recovery. The findings offer insights for other countries and regions adopting rapid antidepressant strategies.