Ketamine vs Electroconvulsive Therapy for Major Depressive Episode
JAMA Psychiatry June 1, 2023 Vikas Menon, Natarajan Varadharajan, Abdul Faheem et al. 50 citations
Electroconvulsive therapy (ECT) appears more effective than ketamine for treating major depressive episodes in adults, though the evidence is limited by small studies. A meta-analysis of five randomized trials (141 ketamine patients, 137 ECT patients) found ECT produced significantly higher response and remission rates one week after treatment. ECT was 27% more likely to achieve response and 43% more likely to achieve remission than ketamine. In methodologically stronger trials, ECT showed a moderate advantage over ketamine on depression rating scales. No significant differences emerged between treatments for number of sessions needed or cognitive side effects. The authors caution that conclusions are tempered by the small number and size of existing trials.