The journal of ECT
January 29, 2026
Sergi López-rodríguez, Aida De Arriba-Arnau, José Manuel Menchón et al.
1 citation
Combining electroconvulsive therapy (ECT) with intranasal esketamine (ESK) may offer sustained improvement for adults with severe treatment-resistant depression who had only partial benefit from either treatment alone. In four patients aged 50 to 72, the combination reduced depression scores by an average of 58% over 24 weeks, with no relapses. Two patients who added the complementary treatment to partial monotherapy showed symptom reductions of 50% and 37%. Two others who were already responding to maintenance ECT had further improvements of 62% and 83%, allowing ECT sessions to be spaced from weekly to every two to three weeks. Side effects were mild and temporary, including brief dissociation and post-ictal confusion. These findings suggest the combination is feasible and warrants controlled trials.
The journal of ECT
January 21, 2025
Daniël T Coerts, Jolien K E Veraart, Jeanine Kamphuis et al.
1 citation
In eight patients with treatment-resistant depression, repeated oral esketamine was tested as a replacement for maintenance electroconvulsive therapy (M-ECT). Over six weeks, esketamine doses were gradually increased up to 3.0 mg/kg twice weekly. Depression severity remained stable or improved in five patients, while three worsened and resumed M-ECT. Among five patients with available scores, all showed improvement on the Outcome Questionnaire 45. Four patients continue to receive oral esketamine. Oral esketamine may offer a suitable, patient-friendly alternative to M-ECT, though controlled trials are needed to confirm long-term safety and efficacy.
The journal of ECT
March 19, 2026
Jennifer Sjödin, Karin Zimmer, Max Bell et al.
Electroconvulsive therapy (ECT) is effective for severe or treatment-resistant major depressive disorder, but anesthesia may reduce its impact by raising the seizure threshold. A review of 59 studies found that ketamine and etomidate produce longer seizures than other anesthetics, though etomidate suppresses cortisol synthesis and ketamine can cause perceptual disturbances. Lower anesthetic doses and longer intervals between anesthesia and ECT are linked to longer seizures and better response, but this has not been confirmed in randomized trials. Clinical outcomes are broadly similar across anesthetics, though ketamine may speed ECT's effect. Anesthetic choice should consider patient factors like cardiovascular health.
The journal of ECT
April 28, 2025
Selin Balki Tekin, Ayşe Nur İnci Kenar, İhsan Anıl Doğruyol et al.
A retrospective analysis of medical records from March 2023 to July 2024 examined 149 patients (mean age 41.72 years, 54.4% female) who received electroconvulsive therapy (ECT). At least one side effect occurred in 23 patients. The number of effective ECT sessions was statistically significantly higher in patients given ketamine alone compared to those given propofol, propofol to ketamine, or a propofol-ketamine combination. No significant relationship was found between anesthetic type and side effects. The combination of ketamine and propofol may be safer regarding side effects and cognitive functions than either alone, and ketamine alone may be a viable alternative when seizures are ineffective.
The journal of ECT
April 15, 2025
Erich J Conrad, Zachary F Stielper, Isabelle V Mermilliod et al.
Catatonia that does not respond to standard medications is often treated with electroconvulsive therapy, but legal delays can postpone this treatment, increasing risks from immobility and leading to procedures like feeding tube placement. A case is presented in which intravenous ketamine successfully resolved catatonia, allowing a patient to avoid complications and additional procedures before receiving electroconvulsive therapy. The authors suggest further research is needed, as ketamine may change the current approach to refractory catatonia.