Ketamine Outperforms ECT in Depression Study

Compared with electroconvulsive therapy (ECT), the anesthetic ketamine was found to have a more rapid onset of antidepressant action as well as more effectiveness in decreasing depression, according to a study reported December 13, 2013, in Psychiatry Research in which 18 hospitalized patients with major depressive disorder were randomized to receive either three infusions of ketamine or three ECT treatments.

The study was conducted by Mehdi Ghasemi, M.D., a postdoctoral research fellow in neurology at Johns Hopkins University, and colleagues.

The primary outcome measures were the Beck Depression Inventory and Hamilton Rating Scale on Depression, which were used to rate overall depressive symptoms at baseline and at 24 hours, 72 hours, and one week after treatment.

“Studies exploring depression treatments that rival the rapid, definitive treatment response of ECT are important,” M. Justin Coffey, M.D., chief of the Consultation-Liaison Psychiatry Services and of the ECT Therapy Service at Henry Ford Behavioral Health Services in Detroit, told Psychiatric News. “[However,] any conclusions drawn from this study are significantly limited by the small sample size and the lack of seizure monitoring (that is, using EEG) during the ECT treatments. In addition, he said, it isn’t clear that comparing a small number of ketamine infusions with a small number of ECT treatments is valid, “when the benefits of ECT become manifest typically over a course of treatments.” ■

An abstract of “Rapid Antidepressant Effects of Repeated Doses of Ketamine Compared With Electroconvulsive Therapy in Hospitalized Patients With Major Depressive Disorder” is posted at http://www.sciencedirect.com/science/article/pii/S0165178113007713.