Ketamine Anesthesia Does Not Improve Depression Scores in Electroconvulsive Therapy: A Randomized Clinical Trial

Journal of Neurosurgical Anesthesiology
Charles William CarspeckenIrene Rozet

Abstract

Although interest in ketamine use during electroconvulsive therapy (ECT) has increased, studies have been equivocal with regard to its efficacy. The aims of this clinical trial were to evaluate ketamine's antidepressive effects in ECT as a primary anesthetic, determine ketamine's tolerability when compared with standard anesthesia, and determine if plasma brain-derived neurotrophic factor (BDNF) is necessary for treatment response. Adults meeting criteria for treatment-resistant depression undergoing index course ECT received either methohexital (1 to 2 mg/kg) or ketamine (1 to 2 mg/kg) anesthesia in this dual-arm double-blinded randomized clinical trial (NCT02752724). The primary outcome of this study is change in depression questionnaire scores before and after ECT. Seizure data, depression severity using self-reported and clinician-assessed questionnaires, cognitive scoring, and plasma BDNF concentrations were obtained before and after completion of ECT. There were no differences in seizure lengths, hemodynamics, or seizure stimuli between the ketamine (n=23;138 ECTs) and methohexital (n=27;159 ECTs) groups. Depression scores improved similarly after ECT in both groups. In the methohexital group, 15% of patients failed to ac...Continue Reading

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Citations

Jul 13, 2018·Journal of Neurosurgical Anesthesiology·Chittaranjan Andrade
May 17, 2019·The Journal of ECT·Takashi TsujiiHiroyuki Uchida
Jan 29, 2019·Journal of Neurosurgical Anesthesiology·Jeffrey J Pasternak
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Jul 3, 2020·Indian Journal of Psychological Medicine·Jagadisha ThirthalliGirish Kunigiri
Aug 28, 2020·The Psychiatric Quarterly·Raheel Imtiaz MemonZheala Qayyum
Nov 26, 2019·The Journal of ECT·Takashi TsujiiHiroyuki Uchida
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Dec 18, 2020·Pharmacological Reviews·Antonio InserraGabriella Gobbi
Apr 3, 2020·Journal of the Neurological Sciences·Molly C KalmoeCharles R Conway
May 26, 2021·Best Practice & Research. Clinical Anaesthesiology·Martin SoehleRicard Valero
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Aug 27, 2021·Current Opinion in Anaesthesiology·Irene Rozet
Nov 18, 2018·British Journal of Anaesthesia·K Hirota, D G Lambert

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Methods Mentioned

BETA
blood collection
enzyme-linked immunosorbent assay

Software Mentioned

STATA
Graphpad Prism

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