Ketamine and electroconvulsive therapy for severe depression: A network meta-analysis of efficacy and safety.
Journal of psychiatric research July 1, 2024 Yecun Liu, Jiguo Yang, Yuanxiang Liu 8 citations
Electroconvulsive therapy (ECT) and ketamine each improve depressive symptoms more than placebo, but ECT appears superior to both ketamine and their combination for reducing depression severity. A network meta-analysis of 17 randomized controlled trials involving 1,370 patients with severe depression found that ECT had the highest probability of being the most effective treatment, followed by the combination of ketamine plus ECT, then ketamine alone, and finally placebo. No significant differences were observed on the Montgomery-Asberg Depression Rating Scale, though rank probabilities again favored ECT. The combination of ketamine and ECT was associated with more adverse reactions, indicating a need for further research on optimal combined use. Individualized treatment decisions remain important.