Volume 28, Issue 150, August 2024

Electroconvulsive therapy versus intravenous ketamine as a novel treatment in depressive disorders: Review of the literature

Marcin Głód¹, Dominika Kabała², Adam Jaskulski³, Agata Zapałowska⁴, Michał Bielecki⁴, Milena Szczepańska⁵, Tymon Zatorski⁶

¹Masovian Bródnowski Hospital, Kondratowicza 8, 03-242 Warsaw, Poland
²University Clinical Centre of the Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland
³The Independent Group of Public Ambulatory Care Institutions Warsaw-Ochota, Szczęśliwicka 36, 02-353 Warsaw, Poland
⁴John Paul II Independent Public Specialist Western Hospital, Daleka 11, 05-825 Grodzisk Mazowiecki, Poland
⁵Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland
⁶The Independent Group of Public Ambulatory Care Institutions Warsaw-Mokotów, Madalińskiego 13, 02-513 Warsaw, Poland

ABSTRACT

Aim: In this review, we assessed the state of available knowledge regarding the antidepressant action of intravenous ketamine versus electroconvulsive therapy (ECT) in randomized clinical trials and clinical trials. Methods: To search for the eligible articles, the PubMed database was used. Five studies were selected using the inclusion criteria, and their findings are presented in our review. Results: Five articles were selected. Three of them showed that ketamine is non-inferior to ECT, and in some patients, it had a faster onset and reduced depressive symptoms more significantly than ECT. Two of the selected articles concluded that ketamine is inferior to ECT. However, it is still a potent treatment that can induce response or remission faster than antidepressant drugs, even in patients suffering from treatment-resistant depression. Discussion and conclusions: As antidepressant properties of ketamine remain a relatively new discovery, further research needs to be conducted regarding its efficacy in the treatment of depressive disorders in relation to ECT, especially trials enrolling more participants. It is vital to note that even if two trials showed the inferiority of ketamine to ECT, all of them concluded that ketamine exhibits strong antidepressant properties and may prove to be an effective treatment, especially when ECT may be contraindicated, or patients are reluctant to it.

Keywords: Depression; major depressive disorder; ketamine; intravenous ketamine; electroconvulsive therapy.

Medical Science, 2024, 28, e105ms3425

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DOI: https://doi.org/10.54905/disssi.v28i150.e105ms3425

Published: 16 August 2024