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.
Journal of affective disorders
February 15, 2025
Zhan-Ming Shi, Xian-Jun Lan, Qing Chen et al.
6 citations
A meta-analysis of five randomized controlled trials involving 664 patients with major depressive disorder or bipolar depression found that intravenous (IV) ketamine produced a greater reduction in depressive symptoms 24 hours after the first treatment compared to electroconvulsive therapy (ECT). However, by the end of treatment, both approaches showed similar rates of response and remission. Neurocognitive outcomes were inconsistent across studies. IV ketamine caused more dissociation, blurred vision, dizziness, and double vision, while ECT led to more muscle pain. The faster onset of antidepressant effects with IV ketamine does not translate into superior long-term outcomes, and larger trials are needed to assess lasting efficacy and safety.
Frontiers in psychiatry
January 1, 2025
Zhan-Ming Shi, Xing-Bing Huang, Yan-Ling Zhou et al.
1 citation
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.