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. 2019 May-Jun;61(3):258-264.
doi: 10.4103/psychiatry.IndianJPsychiatry_386_18.

Comparison of efficacy of ketamine versus thiopentone-assisted modified electroconvulsive therapy in major depression

Amit Jagtiani  1 , Hitesh Khurana  2 , Naveen Malhotra  3
Affiliations

Comparison of efficacy of ketamine versus thiopentone-assisted modified electroconvulsive therapy in major depression

Amit Jagtiani et al. Indian J Psychiatry. 2019 May-Jun.

Abstract

Background: It is well known that depression improves faster with electroconvulsive treatment (ECT) than with antidepressant medications. N-methyl-D-aspartate-receptor antagonists (ketamine) have been shown to have rapid antidepressant effects when given as an intravenous infusion. Faster recovery with ECT is likely when used with ketamine as anesthetic.

Aim: The aim of the study is to compare the outcome of modified electroconvulsive therapy (MECT) in major depressive disorder patients undergoing MECT with ketamine versus thiopentone anesthesia.

Materials and methods: Sixty hospitalized patients (age: 18-45 years) with major depressive disorder (Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision) were randomly allocated to either of the two MECT groups (30 patients each) receiving ketamine or thiopentone as anesthetic agent. The participants were assessed on a weekly basis on Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI).

Results: Ketamine group required significantly lesser number of MECT sessions for achieving remission and had rapid improvement in HAM-D and BDI scores compared to the thiopentone group. Furthermore, the stimulus intensity required to elicit seizures was significantly less and seizure duration was longer in ketamine group compared to the thiopentone group.

Conclusion: The use of ketamine for anesthesia led to rapid recovery from depressive symptoms and seems to be a better option for depressive patients, especially when a rapid response is desired.

Keywords: Depression; electroconvulsive therapy; ketamine; thiopentone.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consort diagram showing recruitment and progress of study participants
See this image and copyright information in PMC

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References

    1. Rihmer Z, Merikangas KR. Mood disorders: Epidemiology. In: Sadock VA, Sadock BJ, Ruiz P, editors. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. 10th ed. Vol. 1. Philadelphia, PA: Williams & Wilkins; 2017. p. 1614.
    1. Jick H, Kaye JA, Jick SS. Antidepressants and the risk of suicidal behaviors. JAMA. 2004;292:338–43. - PubMed
    1. Berman RM, Cappiello A, Anand A, Oren DA, Heninger GR, Charney DS, et al. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000;47:351–4. - PubMed
    1. Harihar C, Dasari P, Srinivas JS. Intramuscular ketamine in acute depression: A report on two cases. Indian J Psychiatry. 2013;55:186–8. - PMC - PubMed
    1. Zarate CA, Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA, et al. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006;63:856–64. - PubMed