Study finds ketamine is at least as effective as electroconvulsive therapy for treating major depression

Health News
Tags :
Health News
Share This :


ketamine
One 10 ml vial of 1000 mg ketamine. Credit: Psychonaught/Wikipedia

A new study led by investigators from Mass General Brigham has found that subanesthetic intravenous ketamine was effective and not inferior to electroconvulsive therapy (ECT) for the treatment of non-psychotic, treatment-resistant depression. Their results are published in the New England Journal of Medicine.

“ECT has been the gold standard for treating severe depression for over 80 years,” said Amit Anand, MD, director of Psychiatry Translational Clinical Trials at Mass General Brigham and Professor of Psychiatry at Harvard Medical School. “But it is also a controversial treatment because it can cause memory loss, requires anesthesia and is associated with social stigma. This is the largest study comparing ketamine and ECT treatments for depression that has ever been done, and the only one that also measured impacts to memory.”

Major depressive disorder (MDD) is a leading cause of disability worldwide and is estimated to affect 21 million adults in the United States. ECT involves inducing a seizure via electrical stimulation of the brain. Ketamine is a low-cost dissociative drug approved by the Food and Drug Administration as a sedative/analgesic and general anesthetic. Previous studies have suggested that low doses of the drug may have rapid antidepressant effects for people with MDD.

The trial was conducted from March 2017 to September 2022 at five sites with 403 patients randomized one-to-one to either receive ECT three times per week or ketamine twice per week for three weeks. Patients were followed for a period of six months after treatment and responded to a depressive symptom self-assessment questionnaire, which also included memory tests and questions about quality of life.

The researchers found that 55 percent of those receiving ketamine and 41 percent of those receiving ECT reported at least a 50 percent improvement in their self-reported depressive symptoms and an improvement in their self-reported quality of life that lasted throughout the six-month monitoring period. ECT treatment was associated with memory loss and musculoskeletal adverse effects. Ketamine treatment was not associated with side effects other than an experience of transient dissociation at the time of treatment.

“For the ever-growing number of patients who do not respond to conventional psychiatric treatments and need a higher level of care, ECT continues to be the most effective treatment in treatment-resistant depression,” said Murat Altinay, MD, Psychiatrist and lead of the trial site at Cleveland Clinic. “This study shows us that intravenous ketamine was non-inferior to ECT for treatment of non-psychotic treatment resistant depression and could be considered as a suitable alternative treatment for the condition.”

The current study is the largest-to-date real-world comparative effectiveness trial of ECT vs. ketamine. The trial took a patient-centered approach, with three types of independent depression ratings (patient, rater, and clinician) captured and no active solicitation of participants.

The authors note that their findings are based on self-reported outcomes and that the trial’s open-label design could have influenced response rates. But the trial’s patient-centeredness and the real-world design may also be a strength, allowing the findings to be more easily translated into clinical practice.

Anand’s team is now working on a follow-up study comparing ECT and ketamine treatments for patients with acute suicidal depression to see if the same promising impact is seen in that population.

“People with treatment-resistant depression suffer a great deal, so it is exciting that studies like this are adding new options for them,” said Anand. “With this real-world trial, the results are immediately transferable to the clinical setting.”

More information:
Anand, A. et al. ECT vs. Ketamine for Non-psychotic Treatment-Resistant Major Depression., New England Journal of Medicine (2023). DOI: 10.1056/NEJMoa2302399

Citation:
Study finds ketamine is at least as effective as electroconvulsive therapy for treating major depression (2023, May 24)
retrieved 24 May 2023
from https://medicalxpress.com/news/2023-05-ketamine-effective-electroconvulsive-therapy-major.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.





Source link

Leave a Reply

Your email address will not be published. Required fields are marked *

Popular News Posts

Categories

Our Exclusive Products

Our Store

Our mission is simple, offer quality products that make our customers lives better at a reasonable price, while ensuring a hassle-free shopping experience. This means that before we bring a product to market, we test it to ensure that it meets our high-level quality standards. Our customer service team understand our products and can answer most every product related question quickly and efficiently. We strive everyday to meet and exceed our customers’ expectations of quality and support! Should we ever fail to meet this expectation – contact us and we will make it right!

Our Value: We are proud of our product and accomplishments, but we typically don’t shout it from the rooftop. Instead, we prefer to let our product and customers do the talking. Our core values can be recognized in our product. The qualities we strive for include:

Pragmatism: We design simple, useful solutions for common needs
Quality: From design to final product, we strive for durable solutions that work
Originality: Creativity and innovation are what makes our product unique
Design: Our minimalist and bold design language focuses on functionality and simplicity that is timeless

0 +

Top Rated Products

0 +

Happy Customers