In people with treatment-resistant depression who do not have psychosis, intravenous ketamine works as well as electroconvulsive therapy (ECT) overall. Among outpatients with moderately severe or severe depression, ketamine produced greater improvement in depressive symptoms than ECT. In contrast, inpatients with very severe depression improved more with ECT early in treatment, though by the end of the three-week course both treatments were similarly effective. Higher premorbid intelligence and a diagnosis of posttraumatic stress disorder were linked to greater improvement with ECT, but not with ketamine. These findings may help patients and clinicians decide between the two treatments.
Short-term spinal cord stimulation (stSCS) significantly improves the likelihood of tracheal decannulation in brain injury patients with disorders of consciousness. In a retrospective study of 81 tracheotomized patients, those receiving stSCS had a decannulation rate of 50.0%, compared to 25.7% in the standard care group. The difference was statistically meaningful, indicating stSCS may be a useful neuromodulation strategy to help these patients breathe without a tracheostomy tube.