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.
Psychiatry Research
November 1, 2019
Jun Dong, S. Min, H. Qiu et al.
26 citations
For patients with major depressive disorder, adding a low dose of ketamine to electroconvulsive therapy (ECT) once a week improved remission rates and reduced psychiatric complications compared with giving ketamine before every ECT session. In a randomized trial of 134 patients, those receiving intermittent ketamine had a complication rate of 4.35%, far lower than the 20.93% rate in the repeated-ketamine group and similar to the 0% rate in the routine ECT group. Both ketamine regimens led to higher remission than ECT alone. Intermittent low-dose ketamine appears to boost ECT's effectiveness while minimizing side effects.
Journal of ECT
January 6, 2020
Qibin Chen, Jun Dong, Jie Luo et al.
22 citations
Adding a low dose of ketamine to electroconvulsive therapy (ECT) for major depressive disorder does not improve overall response, remission, or relapse rates, but it does speed up the treatment's effects. Patients receiving 0.3 mg/kg ketamine before ECT required fewer sessions to achieve a response (median 4 vs. 7 sessions) and remission (median 8 vs. 9 sessions), and also reduced suicidal ideation more quickly (median 3 vs. 6 sessions). The findings suggest ketamine can accelerate the onset of ECT's antidepressant benefits without affecting long-term relapse.
Neuropsychiatric disease and treatment
January 1, 2025
Ying Zhang, Zhaojuan Ke, Jie Luo et al.
3 citations
Major depressive disorder (MDD) is common and carries a high suicide risk. Electroconvulsive therapy (ECT) is highly effective but limited by adverse effects; ketamine/esketamine can boost ECT's efficacy and safety but have their own side effects. Binaural beat music (BBM), a non-invasive therapy, may improve mood and assist (es)ketamine. This 2×2 factorial, randomized, blinded clinical trial recruits 476 MDD patients requiring ECT, randomly assigned to four groups: blank sound with saline, blank sound with esketamine, BBM with saline, or BBM with esketamine. The primary outcome is response rate measured by the Hamilton depression scale; secondary outcomes include remission, suicidal ideation, cognitive function, and side effects. The data are expected to show BBM's potential for optimizing ECT strategies and improving patient outcomes.
Neuropsychiatric disease and treatment
January 1, 2025
Zhaojuan Ke, Ying Zhang, Binyang Cai et al.
1 citation
Miscarriage and the subsequent curettage procedure increase risks of depression, anxiety, and insomnia. Ketamine and its derivative esketamine can prevent postpartum depression and treat depressive symptoms after miscarriage curettage, but side effects limit their use. Ascorbic acid (vitamin C) may enhance esketamine's antidepressant effects while reducing its dosage and adverse effects. This 2×2 factorial, double-blinded, randomized controlled trial will recruit 424 women with miscarriage undergoing painless curettage, allocating them equally to four groups: placebo, esketamine alone, vitamin C alone, or vitamin C plus esketamine.