Ketamine in electroconvulsive therapy for depressive disorder: A systematic review and meta-analysis.
Journal of Psychiatric Research September 1, 2018 Li Ren, Jie Deng, S. Min et al. 48 citations
Electroconvulsive therapy (ECT) is highly effective for depression, and ketamine at sub-anesthetic doses also produces rapid antidepressant effects. This systematic review and meta-analysis of 16 randomized controlled trials involving 928 patients examined whether adding ketamine to ECT improves outcomes. At the end of the ECT course, depressive symptoms were not significantly lower in the ketamine group compared to controls. However, depressive scores were lower after the first and after the third through sixth ECT sessions, particularly when ketamine was used as an add-on anesthetic. Ketamine did not improve overall response or remission rates and increased adverse events, especially cardiovascular and psychiatric side effects. Ketamine may accelerate antidepressant effects during ECT but should be used cautiously due to added risks.