The ‘dissociative anesthetic’ ketamine is showing increasing promise as a safe and effective treatment for intractable depression.
A new randomized trial by US researchers showed that ketamine injections were at least as effective. electroconvulsive therapy (ECT) When treating non-psychotic major depression.
After starting ECT or ketamine therapy, patients in the trial reported an almost immediate improvement in quality of life. Side effects such as nausea and memory loss were common with both treatments, although they were short-lived.
“Statistically, it was a strong finding that ketamine was non-inferior to ECT.” To tell Sanjay Mathieu, a psychopharmacologist at Baylor College of Medicine.
“This study can provide confidence to clinicians and patients that ketamine is a reasonable and safe alternative to ECT, at least in the short-term management of treatment-resistant nonpsychotic depression.”
For nearly 80 years, ECT has remained the standard gold-line treatment for severe depression that has failed other medications and treatments, making ketamine the first real candidate facing ECT. there is
Historically, ketamine has been used clinically for sedation and analgesia to induce a trance-like euphoria in patients.
However, this psychoactive substance has also shown significant mental health benefits in recent years.
Clinical studies have shown that low-dose infusions of ketamine given over an hour can relieve symptoms of depression for weeks at a time. This is surprising given that many antidepressants take up to a month to work and are not very potent.
Early trials on ketamine were so promising that in 2019 the U.S. Food and Drug Administration approved A ketamine-based nasal spray for people with intractable depression and chronic suicidal thoughts.
Research so far A comparison of ECT and ketamine found each therapy to be safe and effective in treating resistant depression.but on the other hand some trials Suggests ECT to be ‘significantly superior’ to ketamine for remission; other studies show ketamine hold 90 percent Description of the effects seen from ECT treatment.
The most recent US trial comparing the two treatments used a larger sample size and focused only on nonpsychotic depression.
Interestingly, when researchers randomly assigned patients to two treatment groups, ECT or ketamine injections, a higher percentage of patients assigned to the ECT group dropped out.
This may be related to the fact that ECT requires general anesthesia whereas a ketamine injection takes about 40 minutes and can be administered while the patient is awake.
Ultimately, the trial included 158 patients with resistant depression who received ECT 3 times a week for 3 weeks and 180 patients who received ketamine injections twice a week for 3 weeks.
These patients were enrolled in clinical trials at multiple institutions along the East Coast, including Yale University, Johns Hopkins University, and Baylor College of Medicine.
A few days after 3 weeks of treatment, patients completed a mental health questionnaire.
Treatment was considered successful if the patient’s depression severity score decreased by at least 50 percent from study entry.
Ultimately, 55 percent of patients responded to ketamine treatment and 41 percent to ECT treatment.
Moderate to severe side effects were slightly more common in the ECT group, at just over 30%.
“Because ECT is commonly used in hospitalized suicidal patients, there is a need for a large-scale comparison of ketamine and ECT in the most severely suicidal patients.” To tell Matthew.
Previous studies have shown that ketamine rapidly reduces suicidal thoughts in more than two-thirds of patients, suggesting this new treatment could be life-saving.
There are so few options available for treating resistant forms of depression that these clues cannot be ignored.
This research NEJM.
